Experiences with nonfunctioning neuroendocrine neoplasms of the pancreas

Aim: We present our experiences in the treatment of nonfunctioning neuroendocrine neoplasms of the pancreas to define the natural history and to suggest proper management. Method: From August 1993 to June 2005, the medical records of 19 patients with the diagnosis of nonfunctioning neuroendocrine (islet cell) neoplasms of the pancreas were retrospectively reviewed with respect to patient characteristics, characteristics of neoplasms, surgical procedures, and long-term outcomes in the Yonsei University Medical Center, Seoul, Korea. Results: The median age of the patients (10 males and 9 females) was 51 years. Abdominal pain and discomfort (58%) were the most frequent symptoms. Tumors with a median size of 3.5 cm were noted in the head of the pancreas in 9 patients and in the body or in the tail of the pancreas in 10 patients. Thirteen patients (68%) had neoplasms with malignant features. Twelve patients (63%) underwent surgical resection, and curative resection was performed in 10 patients (53%). Unresectable neoplasms (p = 0.0055), distant metastases (p = 0.0124), and macroinvasion to adjacent organs (p = 0.024) had significantly adverse effects on the mean survival. Neither palliative surgery nor adjuvant chemoradiation therapy seemed to be effective. Conclusions: Early detection of nonfunctioning neuroendocrine neoplasms of the pancreas is important, and curative resection should be attempted for a good prognosis.