Pancreatic endocrine tumors: a large single-center experience.
OBJECTIVE
Pancreatic endocrine tumors (PETs) are infrequent, which makes large experiences unlikely. Our aim was to describe a large single-center experience with PETs and the use of endoscopic ultrasound (EUS) and a cancer staging system (TNM).


METHODS
This study involves a retrospective analysis of 86 patients (44 men; age, 58 +/- 14 years) who underwent EUS-fine needle aspiration (EUS-FNA). Immunohistochemistry was used. Lesions were classified as recommended by TNM classification.


RESULTS
Typical EUS features were well-demarcated, hypoechoic, solid, homogeneous lesions. Ninety percent had the diagnosis obtained by EUS-FNA. Twelve PETs (14%) were functioning, 8 (9.3%) were cystic, and 14 (16%) were 10 mm or smaller. Nonfunctional PETs and larger lesions were more advanced. The TNM stage was I in 24, II in 10, III in 18, and IV in 34 patients. Sixteen patients (27%) died, and 30 patients (52%) had progression/recurrence during the follow-up (34 +/- 27 months). TNM stage and surgery with curative intent were related to progression. The overall 5-year survival was 60%. The mean survival time was 94 +/- 12 months for stage I, 52 +/- 12 months for stage III, and 54 +/- 7 months for stage IV (P = 0.06).


CONCLUSIONS
Nonfunctional PETs were more common and advanced. The EUS-FNA has a high accuracy for diagnosing PETs. Progression and poorer survival were associated with TNM stage.
Figueiredo
Fátima A F
FA
Unité d'Exploration Médico-Chirurgicale Oncologique, Institut Paoli-Calmettes, Marseille, France. faff@gbl.com.br
Giovannini
Marc
M
Monges
Genevieve
G
Charfi
Slim
S
Bories
Erwan
E
Pesenti
Christian
C
Caillol
Fabrice
F
Delpero
Jean Robert
JR
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D018450:Disease Progression; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000473:pathology*; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate