Pancreatic neuroendocrine tumors (PETs) occurs in approximately 1 per 100 000 people per year and account for only 12% of all pancreatic tumors. Most of them are hormonally active, while about 30% secrete no detectable hormons and are discovered due to a tumor mass effect.
Material and methods: We analysed 178 patients with neuroendocrine tumors (NETs) treated at our department in the last five years. The diagnosis was made by pathohistological examination and patients were classified according to the WHO criteria.
Results: In our group of patients with NETs there were 45 (25.3%) patients with PETs (age range 2571, 51.8 mean). MEN1 was diagnosed in 5 (11.1%) patients and one patient had VHL-syndrome. Almost half of them (44%) were functional (11 insulinomas, 5 gastrinomas, 4 somatostatinomas). According to WHO classification, 17 were well-differentiated tumors (37.7%), 20 well-differentiated carcinomas (44.4%), 6 poorly-differentiated carcinomas (13.3%) and two mixed endocrineexocrine carcinomas (4.4%). At the time of diagnosis in 19 (42.4%) patients metastatic disease was diagnosed. Primary tumor was operated in 26 (57.7%) patients. Tumor recidive was diagnosed in 7 (15.5%) patients (occurrence range 130 months, 10 months mean). All of these patients had partial pancreatic resections, with one having pathologically proven infiltration of operative margins. Metastatic disease developed in 6 (13.3%) patients (occurrence range 1160 months, 2.7 years mean). All the patients with locally recidivant tumor or who developed metastases postoperatively belong to the groups of well- or poorly-diffentiated carcinomas. Unoperated patients were treated with chemotherapy, biotherapy, PRRT or combined. During this period 15 patients died, one patient with well-differentiated tumor died due to non-tumor related cause.
Conclusion: Our data are concordant with the data previously presented in literature. We conclude that the tumor biology as defined by WHO classification is most relevant for the clinical outcome of these patients.