Published online Jul 7, 2020. doi: 10.3748/wjg.v26.i25.3638
Peer-review started: January 10, 2020
First decision: March 6, 2020
Revised: May 8, 2020
Accepted: June 9, 2020
Article in press: June 9, 2020
Published online: July 7, 2020
Pancreatic neuroendocrine neoplasms (pNENs) that produce hormones leading to symptoms are classified as functional tumors, while others are classified as nonfunctional tumors. The traditional view is that functionality is a factor that affects the prognosis of pNEN patients. However, as the sample sizes of studies have increased, researches in recent years have proposed new viewpoints.
To assess whether functionality is an independent factor for predicting the prognosis of pNEN patients.
From January 2004 to December 2016, data of patients who underwent surgery at the primary site for the treatment of pNENs from the Surveillance, Epidemiology, and End Results (SEER) database and West China Hospital database were retrospectively analyzed.
Contemporaneous data from the two databases were analyzed separately as two cohorts and then merged as the third cohort to create a large sample that was suitable for multivariate analysis. From the SEER database, age (P = 0.006) and T stage (P < 0.001) were independent risk factors affecting the survival. From the West China Hospital database, independent prognostic factors were age (P = 0.034), sex (P = 0.032), and grade (P = 0.039). The result of the cohort consisting of the combined populations from the two databases showed that race (P = 0.015), age (P = 0.002), sex (P = 0.032) and T stage (P < 0.001) were independent prognostic factors. In the West China Hospital database and in the total population, nonfunctional pNETs and other functional pNETs tended to have poorer prognoses than insulinoma. However, functionality was not associated with the survival time of patients with pNETs in the multivariate analysis.
Functionality is not associated with prognosis. Race, age, sex, and T stage are independent factors for predicting the survival of patients with pNETs.
Core tip: Pancreatic neuroendocrine tumors (pNETs) are classified into functional and nonfunctional tumors according to the existence of hormones related symptoms or not. The traditional view is that functionality is correlated with the prognosis of pNET patients, which remains a controversial opinion. In this study, we retrospectively analyzed the clinicopathological data of 426 patients from the Surveillance, Epidemiology, and End Results database and 205 patients from the West China Hospital database. The results indicated that functionality is not associated with prognosis. Race, age, sex, and T stage are independent factors for predicting the survival of patients with pNETs.