Proactive multi-modality treatment of Pancreatic Neuroendocrine Tumours (PNETs): Potential survival benefits

Tanno, L., Mayo, D., Mills, S., Takhar, A., Cave, J., Nolan, L., Stedman, B., Sundram, F.X., Abu Hilal, M., Connor, H., Pearce, N. and Armstrong, T. (2018) Proactive multi-modality treatment of Pancreatic Neuroendocrine Tumours (PNETs): Potential survival benefits. Pancreatology, 18 (3), 304-312. (doi:10.1016/j.pan.2017.12.006).

Abstract

Background/objectives

Primary and metastatic pancreatic neuroendocrine tumours (PNET) can be treated with combination of surgery, locoregional and systemic therapy. Survival benefits from individual treatments have been well reported, however, the combined outcome from multimodal treatments are not well described in the literature. We report outcomes in a cohort of PNET patients treated with proactive, multimodality therapy.


Methods

106 patients were identified from a single tertiary referral centre prospective database. Outcomes of treatment were studied, with the primary end point being death from any cause.


Results

Median follow-up was 71 months and overall 5-year survival of 62%. In patients with stage I-III disease (51 patients) estimated 5-year survival was 90%. Median survival in patients with stage IV disease was 51 months with an estimated 5-year survival of 40% in this group. A total of 80 patients (75%) had surgery of which 16% suffered complications requiring intervention. There was no perioperative mortality.


Conclusions

This study demonstrates that proactive multimodal treatment is safe and may confer a survival benefit to patients in this cohort

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