A Preoperative Prognostic Score for Resected Pancreatic and Periampullary Neuroendocrine Tumours

A Preoperative Prognostic Score for Resected Pancreatic and Periampullary Neuroendocrine Tumours

Abstract
Background/Aims: To identify potential preoperative prognostic factors in resected pancreatic and periampullary neuroendocrine tumours. Methods: Clinico-pathological data for 54 consecutive patients with pancreatic or periampullary neuroendocrine tumours referred to our institution over a 10-year period were identified from a prospective database.

Results: 34 patients underwent pancreatic resection (12 males, 22 females; median age 54 (IQR 44–71) years). There was a single 30-day mortality (3%). Nodal status (log rank, p = 0.652), microscopic resection margin involvement (p=0.549) and tumour size (p= 0.122) failed to exhibit any prognostic value. Only the presence of malignant tumour characteristics was associated with poorer overall survival (p=0.008). Analysis of preoperative parameters showed that age 1 60 years (p = 0.056), platelet-lymphocyte ratio 1 300 (p=0.008), alkaline phosphatase levels 1 125 U/l (p=0.042) and alanine aminotransferase 1 35 U/l (p = 0.016) were adverse prognostic factors. A risk stratification score was generated where each adverse preoperative parameter was allocated a score of 1. A cumulative score of ^ 1 was defined as low risk, while a score of 6 2 was defined as high risk. Median overall survival in the high-risk group was 10.4 months, while the median survival in the low-risk group was 1 60 months (p ! 0.001).

Conclusion: Significant prognostic information can be gained from routine preoperative biochemistry and haematology results in resected pancreatic and periampullary neuroendocrine tumours. These findings merit further evaluation in a larger patient cohort.

Copyright © 2009 S. Karger AG, Basel and IAP

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