ホンダ　ゴロウ   HONDA Gorou   本田　五郎    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Factors Affecting Nonfunctioning Small Pancreatic Neuroendocrine Neoplasms and Proposed New Treatment Strategies
掲載誌名	正式名：Clinical gastroenterology and hepatology 略　 称：Clin Gastroenterol Hepatol ISSNコード：15427714/15423565
掲載区分	国外
巻・号・頁	22(7),pp.1416-1426
著者・共著者	HIJIOKA Susumu, YAMASHIGE Daiki, ESAKI Minoru, HONDA Goro, HIGUCHI Ryota, MASUI Toshihiko, SHIMIZU Yasuhiro, OHTSUKA Masayuki, KUMAMOTOo Yusuke, KATANUMA Akio, GOTOHDA Naoto, AKITA Hirofumi, UNNO Michiaki, ENDO Itaru, YOKOYAMA Yukihiro, YAMADA Suguru, MATSUMOTO Ippei, OHTSUKA Takao, HIRANO Satoshi, YASUDA Hiroaki, KAWAI Manabu, AOKI Taku, NAKAMURA Masafumi, HASHIMOTO Daisuke, RIKIYAMA Toshiki, HORIGUCHI Akihiko, FUJII Tsutomu, MIZUNO Shugo, HANADA Keiji, TANI Masaji, HATORI Takashi, ITO Tetsuhide, OKUNO Masataka, KAGAWA Shingo, TAJIMA Hiroshi, ISHII Tatsuya, SUGIMOTO Motokazu, ONOE Shunsuke, TAKAMI Hideki, TAKADA Ryoji, MIURA Takayuki, KURITA Yusuke, KAMEI Keiko, MATAKI Yuko, OKAZAKI Kazuichi, TAKEYAMA Yoshifumi, YAMAUE Hiroki, SATOI Sohei,
発行年月	2024/07
概要	BACKGROUND & AIMS:Despite previously reported treatment strategies for nonfunctioning small (≤20 mm) pancreatic neuroendocrine neoplasms (pNENs), uncertainties persist. We aimed to evaluate the surgically resected cases of nonfunctioning small pNENs (NF-spNENs) in a large Japanese cohort to elucidate an optimal treatment strategy for NF-spNENs.METHODS:In this Japanese multicenter study, data were retrospectively collected from patients who underwent pancreatectomy between January 1996 and December 2019, were pathologically diagnosed with pNEN, and were treated according to the World Health Organization 2019 classification. Overall, 1490 patients met the eligibility criteria, and 1014 were included in the analysis cohort.RESULTS:In the analysis cohort, 606 patients (59.8%) had NF-spNENs, with 82% classified as grade 1 (NET-G1) and 18% as grade 2 (NET-G2) or higher. The incidence of lymph node metastasis (N1) by grade was significantly higher in NET-G2 (G1: 3.1% vs G2: 15.0%). Independent factors contributing to N1 were NET-G2 or higher and tumor diameter ≥15 mm. The predictive ability of tumor size for N1 was high. Independent factors contributing to recurrence included multiple lesions, NET-G2 or higher, tumor diameter ≥15 mm, and N1. However, the independent factor contributing to survival was tumor grade (NET-G2 or higher). The appropriate timing for surgical resection of NET-G1 and NET-G2 or higher was when tumors were >20 and >10 mm, respectively. For neoplasms with unknown preoperative grades, tumor size >15 mm was considered appropriate.CONCLUSIONS:NF-spNENs are heterogeneous with varying levels of malignancy. Therefore, treatment strategies based on tumor size alone can be unreliable; personalized treatment strategies that consider tumor grading are preferable.
DOI	10.1016/j.cgh.2024.03.029
PMID	38615727