A Preoperative Prognostic Score for Resected Pancreatic and Periampullary Neuroendocrine TumoursSakka N. · Smith R.A. · Whelan P. · Ghaneh P. · Sutton R. · Raraty M. · Campbell F. · Neoptolemos J.P.
aDivision of Surgery and Oncology, School of Cancer Studies, University of Liverpool, and bDepartment of Pathology, Royal Liverpool University Hospital, Liverpool, UK
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 >60 years (p = 0.056), platelet-lymphocyte ratio >300 (p = 0.008), alkaline phosphatase levels >125 U/l (p = 0.042) and alanine aminotransferase >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 ≥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 >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.
Prof. J.P. Neoptolemos, FMedSci
Owen and Ellen Evans Chair of Cancer Studies, Division of Surgery and Oncology
School of Cancer Studies, Royal Liverpool University Hospital
5th Floor UCD Building, Daulby St, Liverpool L69 3GA (UK)
Tel. +44 151 706 4175, Fax +44 151 706 5798, E-Mail firstname.lastname@example.org
Financial support: Cancer Research UK.
Received: May 8, 2008
Accepted after revision: October 29, 2008
Published online: August 14, 2009
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 3, Number of References : 25
Vol. 9, No. 5, Year 2009 (Cover Date: November 2009)
Journal Editor: Urrutia R. (Rochester, Minn.)
ISSN: 1424-3903 (Print), eISSN: 1424-3911 (Online)
For additional information: http://www.karger.com/PAN