Novel recurrence risk stratification of resected pancreatic neuroendocrine tumor.

摘要: Radical surgical resection represents the only hope of cure for pancreatic neuroendocrine tumor (PanNET). Adjuvant therapy is rarely used because there no evidence to distinguish patients with high recurrence risk. Here we investigated feature resected PanNET and established a novel risk stratification predict its recurrence. We analyzed 505 who underwent R0 at our institute from January 2004 through May 2015. The median follow-up was 71months (range: 12months-143months), 129 (25.5%) experienced disease-free survival (mDFS) 19months. Restricted cubic spline (RCS) functions revealed positive, linear relationship between Ki-67 index Multivariate analysis showed T stage, N insulinoma were independent predictors (P < 0.05). Based on scores these factors, generated recurrent-risk stage system HCI 0.806, superior TNM (HCI 0.704) grading 0.706). Resected classified into low (65.3%, mDFS not reached), intermediate (16.6%, 48months, 95%CI 26.5-73.4), (13.3%, 24months, 19.4-50.5) very (4.8%, 10months, 6.9-13.0) (Hazard ratio: 2.650, 95%CI: 2.233-3.145, P < 0.001). This thus identified different recurrent-risk. Patients may be suitable post-operative clinical trials investigating adjuvant treatment.