Given the lack of consensus on surveillance guidelines after pancreatic neuroendocrine tumor
(PanNET) resection, we assessed outcomes in a large cohort of patients with nonmetastatic, surgically resected PanNETs.
Data of patients with PanNETs resected between 1990 and 2017 were retrospectively collected using databases at 3 academic institutions. The National Death Index was queried to determine vital status. Kaplan-Meier analysis was used to estimate recurrence
-free survival (RFS) and disease-specific survival (DSS) rates. Variables associated with recurrence
and disease-related death were identified through Cox multivariate analyses.
Of 307 patients with PanNET who underwent resection, recurrence
occurred in 79 (26%) of patients. For stage I and II disease, 5-year RFS rates were 90% and 43%, whereas 5-year DSS rates were 98% and 86% (P
< 0.0001 and P
= 0.0038, respectively). For grades 1, 2, and 3 disease, 5-year RFS rates were 87%, 49%, and 18%, and 5-year DSS rates were 98%, 89%, and 51% (P
< 0.0001 for both). Stage II, grade 2, and grade 3 disease were each associated with increased recurrence
and disease-specific death.
Stage and grade are important prognostic factors that should be utilized to tailor postsurgical surveillance after curative resection of PanNET.