title: Resection versus expectant management of small incidentally discovered nonfunctional pancreatic neuroendocrine tumors.
abstract: BACKGROUND
  Sporadic, nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) are diagnosed with increasing frequency. We compared the risk of tumor growth, metastasis, and mortality between patients treated versus those treated expectantly.
  
  
  METHODS
  A retrospective study of patients seen at our institution with sporadic NF-PNETs, with ≥ 12 months of follow-up. Kaplan-Meier analysis was performed.
  
  
  RESULTS
  Between 1999 and 2014, 35 patients with an incidentally discovered nonfunctional PNET were identified. Twenty underwent resection and 15 were followed with imaging. In the operative group, 8 had NF-PNETs < 2 cm, while 12 had NF-PNETs ≥ 2 cm. In the nonoperative expectant management by serial imaging group, 10 had NF-PNETs < 2 cm while 5 had NF-PNETs ≥ 2 cm. Small NF-PNETs (<2 cm) in either the operative or nonoperative groups demonstrated no evidence of progression or metastasis (median follow-up of 27.8 months). Morbidity in the operative group was 35% with pancreatic pseudocyst the most common.
  
  
  CONCLUSIONS
  Incidentally discovered NF-PNETs < 2 cm in size can be observed safely with serial imaging.
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Alex M
authors.initials: AM
authors.lastname: Rosenberg
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Patricia
authors.initials: P
authors.lastname: Friedmann
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Bronx, NY.
authors.forename: Jaydira
authors.initials: J
authors.lastname: Del Rivero
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Bronx, NY.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Libutti
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY; Montefiore Medical Center, Bronx, NY. Electronic address: Alaird@montefiore.org.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Laird
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018579:Patient Selection; D011379:Prognosis; D012189:Retrospective Studies; D057832:Watchful Waiting