Prognostic factors after resection of locally advanced non-functional pancreatic neuroendocrine neoplasm: an analysis from the German Cancer Registry Group of the Society of German Tumor Centers

Thaer S.A. Abdalla*, Monika Klinkhammer-Schalke, Sylke Ruth Zeissig, Kees Kleihues van Tol, Kim C. Honselmann, Rüdiger Braun, Louisa Bolm, Hryhoriy Lapshyn, Stanislav Litkevych, Sergii Zemskov, Nehara Begum, Birte Kulemann, Richard Hummel, Ulrich Friedrich Wellner, Tobias Keck*, Steffen Deichmann

*Corresponding author for this work
1 Citation (Scopus)


Objective: The available literature regarding outcome after pancreatic resection in locally advanced non-functional pNEN (LA-pNEN) is sparse. Therefore, this study evaluates the current survival outcomes and prognostic factors in after resection of LA-pNEN. Materials and methods: This population-based analysis was derived from 17 German cancer registries from 2000 to 2019. Patients with upfront resected non-functional non-metastatic LA-pNEN were included. Results: Out of 2776 patients with pNEN, 277 met the inclusion criteria. 137 (45%) of the patients were female. The median age was 63 ± 18 years. Lymph node metastasis was present in 45%. G1, G2 and G3 pNEN were found in 39%, 47% and 14% of the patients, respectively. Resection of LA-pNEN resulted in favorable 3-, 5- and 10-year overall survival of 79%, 74%, and 47%. Positive resection margin was the only potentially modifiable independent prognostic factor for overall survival (HR 1.93, 95% CI 1.71–3.69, p value = 0.046), whereas tumor grade G3 (HR 5.26, 95% CI 2.09–13.25, p value < 0.001) and lymphangiosis (HR 2.35, 95% CI 1.20–4.59, p value = 0.012) were the only independent prognostic factors for disease-free survival. Conclusion: Resection of LA-pNEN is feasible and associated with favorable overall survival. G1 LA-pNEN with negative resection margins and absence of lymph node metastasis and lymphangiosis might be considered as cured, while those not fulfilling these criteria might be considered as a high-risk group for disease progression. Herein, negative resection margins represent the only potentially modifiable prognostic factor in LA-pNEN but seem to be influenced by tumor grade.

Original languageEnglish
JournalJournal of Cancer Research and Clinical Oncology
Issue number11
Pages (from-to)8535-8543
Number of pages9
Publication statusPublished - 09.2023

DFG Research Classification Scheme

  • 205-25 General and Visceral Surgery

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