title: Pancreatic neuroendocrine tumor: A multivariate analysis of factors influencing survival.
abstract: BACKGROUND
  The outcomes of pancreatic neuroendocrine tumors are extremely diverse, and determining the best strategy, optimal timing of therapy and the therapeutic results depend on understanding prognostic factors. We determined the clinical, radiological and histological factors associated with survival and tumor recurrence for patients with pancreatic neuroendocrine tumor.
  
  
  METHODS
  From January 1, 1991 to December 31, 2011, 127 patients with pancreatic neuroendocrine tumor underwent pancreatectomy. The variables including clinical characteristics, surgical data and pathological findings were examined by univariate and multivariate analyses.
  
  
  RESULTS
  There were 103 patients with non-functional tumors (81%). Sixty-four patients (50%) underwent left pancreatectomy, 51 (42%) patients underwent pancreatico-duodenectomy, 12 (9%) patients underwent enucleation and 2 patients (1%) underwent central pancreatectomy. Forty-eight patients (38%) had synchronous liver metastases. Six patients (5%) required portal vein resection, and 19 (15%) patients required enlarged "en-bloc" resection of adjacent organs. The overall morbidity and mortality rates were 48% and 2.3%, respectively. The 1-, 3- and 5-year overall survival rates were 94%, 84%, and 74%, respectively. In multivariate analyses, synchronous liver metastases (p = 0.02) and portal vein resection (p < 0.01) were independent prognostic factors of survival.
  
  
  CONCLUSIONS
  Synchronous liver metastases and portal vein resection were found to be independent factors influencing survival.
authors.affiliation: Department of Digestive Surgery, Hôpital Nord, Aix-Marseille Université, Chemin des Bourrely, Marseille cedex 20, 13915 France. Electronic address: david.birnbaum@ap-hm.fr.
authors.forename: D J
authors.initials: DJ
authors.lastname: Birnbaum
authors.affiliation: Department of Surgical Oncology, Institut Paoli-Calmettes, Aix-Marseille Université, France.
authors.forename: O
authors.initials: O
authors.lastname: Turrini
authors.affiliation: Department of Surgical Oncology, Institut Paoli-Calmettes, Aix-Marseille Université, France.
authors.forename: J
authors.initials: J
authors.lastname: Ewald
authors.affiliation: Department of Digestive Surgery and Liver Transplantation, Hôpital La Conception, Aix-Marseille Université, France.
authors.forename: L
authors.initials: L
authors.lastname: Barbier
authors.affiliation: Department of Biostatistics, Institut Paoli-Calmettes, Aix-Marseille Université, France.
authors.forename: A
authors.initials: A
authors.lastname: Autret
authors.affiliation: Department of Digestive Surgery and Liver Transplantation, Hôpital La Conception, Aix-Marseille Université, France.
authors.forename: J
authors.initials: J
authors.lastname: Hardwigsen
authors.affiliation: Department of Digestive Surgery, Hôpital Nord, Aix-Marseille Université, Chemin des Bourrely, Marseille cedex 20, 13915 France.
authors.forename: C
authors.initials: C
authors.lastname: Brunet
authors.affiliation: Department of Digestive Surgery, Hôpital Nord, Aix-Marseille Université, Chemin des Bourrely, Marseille cedex 20, 13915 France.
authors.forename: V
authors.initials: V
authors.lastname: Moutardier
authors.affiliation: Department of Digestive Surgery and Liver Transplantation, Hôpital La Conception, Aix-Marseille Université, France.
authors.forename: Y-P
authors.initials: YP
authors.lastname: Le Treut
authors.affiliation: Department of Surgical Oncology, Institut Paoli-Calmettes, Aix-Marseille Université, France.
authors.forename: J-R
authors.initials: JR
authors.lastname: Delpero
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011169:Portal Vein / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: Liver metastases; Neuroendocrine tumor; Pancreatic surgery; Prognostic factor; Survival