Neuroendocrine tumors of pancreas: how can we apply the 2006 TNM proposal?
OBJECTIVE
In 2006, a TNM system for foregut neuroendocrine tumors has been proposed. Our study aimed to present the management of neuroendocrine tumors of pancreas according to this classification and to highlight some of its limitations.


METHODS
Clinical, biochemical, radiological, surgical and pathological data were retrospectively collected on 22 consecutives patients, who underwent surgery for neuroendocrine tumors of pancreas between November, 1991 and September, 2005. These data were used to set the TNM.


RESULTS
After excluding 5 patients, the remaining 17 patients were analyzed. In 9 patients, with a mean age of 39 years, tumors were benign with a mean size of 1.8 cm, classed at stage I-IIa, whereas for 8 patients with a mean age of 57 years, tumors were malignant with a mean size of 6cm and were classed at stage IIb-IV. There were 3 deaths in stage IIb-IV, and none in stage I-IIa.


CONCLUSIONS
TNM may be considered as a useful tool for prognostic stratification, but true benign tumors need to be excluded in order to improve the classification. Size and age appeared as variables affecting malignant behavior and the prognosis.
Mboti
Freddy B
FB
Medicosurgical Department of Hepatogastroenterology, Pancreatology, ULB Erasme Hospital, Route de Lennik, 808, 1070 Brussels, Belgium. freddy.mboti@erasme.ulb.ac.be
Loi
Patrizia
P
Nagy
Nathalie
N
Myriam
Delhaye
D
Gelin
Michel
M
Closset
Jean
J
D000328:Adult; D000368:Aged; D001706:Biopsy; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D018709:Statistics, Nonparametric