Outcomes of resected nonfunctional XXXX : Do size and symptoms matter?

@entity5 @entity1 @entity788
BACKGROUND: Nonfunctional @entity788 (NF-PNETs) are rare @entity5 with highly variable outcome. Current guidelines recommend surveillance for small @entity5 ( <=2  cm), but a scientific basis for such recommendation is scarce. METHODS: @entity1 who underwent surgery for NF-PNET during 2001-2013 were identified from a prospectively maintained database and reviewed retrospectively. RESULTS: Fifty-eight @entity1 that had undergone an operative procedure for NF-PNET were identified. Forty-one @entity1 (71%) were symptomatic. Median size of the @entity5 was 2.5  cm (range 0.9-12.0  cm). WHO 2010 grade was predictive of both overall- and disease-free survival (P  <  .001), whereas size alone was not. Twenty-four @entity1 had a small NF-PNET ( <=2  cm), of whom 16 were symptomatic and 8 asymptomatic. Seven @entity1 with small symptomatic NF-PNETs showed signs of malignant behavior: 4 had lymph node metastases, 1 had liver metastases before surgery, 3 developed liver metastases, and 3 died of the disease. All 7 @entity1 had either bile duct or @entity788 or both on preoperative imaging. On the contrary, @entity1 with small asymptomatic NF-PNETs did not develop distant metastases nor died of disease. CONCLUSION: The 2010 grading system from the World Health Organization can be used to predict survival. Symptomatic small NF-PNETs that caused bile and/or @entity788 had poor outcome. In contrast, asymptomatic small NF-PNETs seem to have benign course, and are candidates for surveillance.
