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Prognostic factors of non-functioning pancreatic neuroendocrine tumor revisited: The value of WHO 2010 classification
Ann Hepatobiliary Pancreat Surg 2018 Feb;22(1):66-74
Published online February 28, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Jiyoung Bu1,*, Sangmin Youn1,*, Wooil Kwon1,2, Kee Taek Jang3, Sanghyup Han1, Sunjong Han1, Younghun You1, Jin Seok Heo1, Seong Ho Choi1, and Dong Wook Choi1

1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 2Department of Surgery, Seoul National University College of Medicine, 3Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Received November 6, 2016; Revised August 23, 2017; Accepted August 31, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Backgrounds/Aims: Various factors have been reported as prognostic factors of non-functional pancreatic neuroendocrine tumors (NF-pNETs). There remains some controversy as to the factors which might actually serve to successfully prognosticate future manifestation and diagnosis of NF-pNETs. As well, consensus regarding management strategy has never been achieved. The aim of this study is to further investigate potential prognostic factors using a large single-center cohort to help determine the management strategy of NF-pNETs. Methods: During the time period 1995 through 2013, 166 patients with NF-pNETs who underwent surgery in Samsung Medical Center were entered in a prospective database, and those factors thought to represent predictors of prognosis were tested in uni- and multivariate models. Results: The median follow-up time was 46.5 months; there was a maximum follow-up period of 217 months. The five-year overall survival and disease-free survival rates were 88.5% and 77.0%, respectively. The 2010 WHO classification was found to be the only prognostic factor which affects overall survival and disease-free survival in multivariate analysis. Also, pathologic tumor size and preoperative image tumor size correlated strongly with the WHO grades (p<0.001, and p<0.001). Conclusions: Our study demonstrates that 2010 WHO classification represents a valuable prognostic factor of NF-pNETs and tumor size on preoperative image correlated with WHO grade. In view of the foregoing, the preoperative image size is thought to represent a reasonable reference with regard to determination and development of treatment strategy of NF-pNETs. (Ann Hepatobiliary Pancreat Surg 2018;22:66-74)
Keywords : NF-pNETs; 2010 WHO classification; Prognostic factors; Image tumor size


February 2018, 22 (1)