TY - JOUR
T1 - Early and Late Complications after Surgery for MEN1-related Nonfunctioning Pancreatic Neuroendocrine Tumors
AU - Nell, Sjoerd
AU - Borel Rinkes, Inne H. M.
AU - Verkooijen, Helena M.
AU - Bonsing, Bert A.
AU - van Eijck, Casper H.
AU - van Goor, Harry
AU - de Kleine, Ruben H. J.
AU - Kazemier, Geert
AU - Nieveen van Dijkum, Elisabeth J.
AU - Dejong, Cornelis H. C.
AU - Valk, Gerlof D.
AU - Vriens, Menno R.
PY - 2018
Y1 - 2018
N2 - Objective: To estimate short and long-term morbidity after pancreatic surgery for multiple endocrine neoplasia type 1 (MEN1)-related nonfunctioning pancreatic neuroendocrine tumors (NF-pNETs). Background: Fifty percent of the MEN1 patients harbor multiple NF-pNETs. The decision to proceed to NF-pNET surgery is a balance between the risk of disease progression versus the risk of surgery-related morbidity. Currently, there are insufficient data on the surgical complications after MEN1 NF-pNET surgery. Methods: MEN1 patients diagnosed with a NF-pNET who underwent surgery were selected from the DutchMEN1 study group database, including >90% of the Dutch MEN1 population. Early postoperative complications, new-onset diabetes mellitus, and exocrine pancreatic insufficiency were captured. Results: Sixty-one patients underwent NF-pNET surgery at 1 of the 8 Dutch academic centers. Patients were young (median age 41 years) with low American Society of Anesthesiologists scores. Median NF-pNET size on imaging was 22mm (3-157). Thirty-three percent (19/58) of the patients developed major early - Clavien-Dindo grade III to IV - complications mainly consisting International Study Group of Pancreatic Surgery grade B/C pancreatic fistulas. Twenty-three percent of the patients (14/61) developed endocrine or exocrine pancreas insufficiency. The development of major early postoperative complications was independent of the NF-pNET tumor size. Twenty-one percent of the patients (12/58) developed multiple major early complications. Conclusions: MEN1 NF-pNET surgery is associated with high rates of major short and long-term complications. Current findings should be taken into account in the shared decision-making process when MEN1 NF-pNET surgery is considered.
AB - Objective: To estimate short and long-term morbidity after pancreatic surgery for multiple endocrine neoplasia type 1 (MEN1)-related nonfunctioning pancreatic neuroendocrine tumors (NF-pNETs). Background: Fifty percent of the MEN1 patients harbor multiple NF-pNETs. The decision to proceed to NF-pNET surgery is a balance between the risk of disease progression versus the risk of surgery-related morbidity. Currently, there are insufficient data on the surgical complications after MEN1 NF-pNET surgery. Methods: MEN1 patients diagnosed with a NF-pNET who underwent surgery were selected from the DutchMEN1 study group database, including >90% of the Dutch MEN1 population. Early postoperative complications, new-onset diabetes mellitus, and exocrine pancreatic insufficiency were captured. Results: Sixty-one patients underwent NF-pNET surgery at 1 of the 8 Dutch academic centers. Patients were young (median age 41 years) with low American Society of Anesthesiologists scores. Median NF-pNET size on imaging was 22mm (3-157). Thirty-three percent (19/58) of the patients developed major early - Clavien-Dindo grade III to IV - complications mainly consisting International Study Group of Pancreatic Surgery grade B/C pancreatic fistulas. Twenty-three percent of the patients (14/61) developed endocrine or exocrine pancreas insufficiency. The development of major early postoperative complications was independent of the NF-pNET tumor size. Twenty-one percent of the patients (12/58) developed multiple major early complications. Conclusions: MEN1 NF-pNET surgery is associated with high rates of major short and long-term complications. Current findings should be taken into account in the shared decision-making process when MEN1 NF-pNET surgery is considered.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84994245997&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/27811505
U2 - https://doi.org/10.1097/SLA.0000000000002050
DO - https://doi.org/10.1097/SLA.0000000000002050
M3 - Article
C2 - 27811505
SN - 0003-4932
VL - 267
SP - 352
EP - 356
JO - Annals of surgery
JF - Annals of surgery
IS - 2
ER -