title: Clinical outcome and long-term survival in 118 consecutive patients with neuroendocrine tumours of the pancreas.
abstract: BACKGROUND
  The aim was to assess the clinical relevance of the World Health Organization and tumour node metastasis (TNM) classifications in patients with pancreatic neuroendocrine tumours (pNETs).
  
  
  METHODS
  Prospectively collected data from 118 consecutive patients with a pNET receiving surgical intervention were analysed.
  
  
  RESULTS
  Forty-one patients had well differentiated neuroendocrine tumours, 64 had well differentiated neuroendocrine carcinomas and 13 had poorly differentiated neuroendocrine carcinomas. Five-year survival rates were 95, 44 and 0 per cent respectively (P < 0.001). There was no difference in survival after R0 and R1/R2 resections in patients with neuroendocrine carcinomas (P = 0.905). In those with well differentiated neuroendocrine carcinomas, any resection and having a clinically non-functional tumour significantly increased survival (P = 0.003 and P = 0.037 respectively). The TNM stage was I in 37 patients, II in 15 patients, III in 32 patients and IV in 34 patients. There were significant differences in 5-year survival between stage I and II (88 and 85 per cent respectively) and stage III and IV (31 and 42 per cent respectively) (P = 0.010).
  
  
  CONCLUSIONS
  Both classifications accurately reflect the clinical outcome of patients with pNET. The resection status may not be critical for long-term survival in patients with pNET.
authors.affiliation: Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Fischer
authors.forename: J
authors.initials: J
authors.lastname: Kleeff
authors.forename: I
authors.initials: I
authors.lastname: Esposito
authors.forename: U
authors.initials: U
authors.lastname: Hinz
authors.forename: A
authors.initials: A
authors.lastname: Zimmermann
authors.forename: H
authors.initials: H
authors.lastname: Friess
authors.forename: M W
authors.initials: MW
authors.lastname: Büchler
mesh_terms: D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000145:classification / Q000401:mortality* / Q000601:surgery; D010180:Pancreatectomy / Q000401:mortality / Q000706:statistics & numerical data; D010190:Pancreatic Neoplasms / Q000145:classification / Q000401:mortality* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome