New England Surgical Society (NESS)
Search NESS
  Annual Meeting
  Annual Resident and Fellow Research Day
      Member Directory
      Members Only
  Scholars Foundation
  Job Board
  Journal of the American College of Surgeons
      Past Presidential Addresses
  Contact NESS

NESS 2006 Annual Meeting
Back to Scientific Program
Back to Annual Meeting

Evolving Patterns in the Detection of Pancreatic Neuroendocrine Tumors (PNETs): The Massachusetts General Hospital Experience from 1977-2005
Parsia A Vagefi, Oswaldo Razo, Vikram Deshpande, Gregory Y. Lauwers, Sarah P. Thayer, Andrew L. Warshaw, Carlos Fernandez-Del Castillo
Massachusetts General Hospital/Harvard Medical School, Boston, MA

Objective: To assess changing patterns in the detection of PNETs.
Design: Retrospective review from 1977 to 2005.
Setting: Tertiary care referral center.
Patients: 172 patients (51 % male, mean age 55 years) who underwent surgery for histologically confirmed PNETs.
Main Outcome Measures: Surgical outcomes, survival, and changes in presentation of PNETs in 2 time groups: 1977-1999 (80 patients) and 2000-2005 (92 patients).
Results: Ninety-seven patients (56.4%) had non-functioning PNETs, 83 of which were incidental. Insulinomas were the most common of functioning tumors (33%), then gastrinomas and glucagonomas; 12 patients (7%) had MEN 1. Overall, 60% of tumors were located in the pancreatic body or tail. A Whipple procedure was performed in 23%, distal pancreatectomy in 53%, and the rest had either middle pancreatectomy or enucleation. There were no operative deaths. 74% of tumors were classified as benign; of those classified as malignant, 25% had liver metastases. 10.5% of patients received adjuvant therapy. Complete follow up was available in 90% of patients (mean duration 63.3 months). The 5 and 10-year actuarial survival were 77% and 62%, respectively. Incidentally-discovered non-functioning tumors were significantly more frequent in the last five years (58% vs 38%, p=0.01), with a trend towards smaller tumors (4.2 vs 5.6 cm, p=0.19), and lesser likelihood of malignancy (21% vs 40%, p=0.1).
Conclusion: We report here the largest single center experience with PNETs. Increasing number of PNETs are being resected, largely due to incidental detection of non-functioning neoplasms. This may be leading to treatment of smaller and less malignant tumors.

Back to Scientific Program
Back to Annual Meeting

Copyright © 2021 New England Surgical Society. All Rights Reserved.
Read Privacy Policy.