Implementation of Current ENETS Guidelines for Surgery of Small (2cm) Pancreatic Neuroendocrine Neoplasms in the German Surgical Community: An Analysis of the Prospective DGAV StuDoQ|Pancreas Registry

Mintziras I, Keck T, Werner J, Fichtner-Feigl S, Wittel U, Senninger N, Vowinkel T, Koeninger J, Anthuber M, Geissler B, Bartsch DK, Ghadimi M, Post S, Wilhelm TJ, Germer CT, Uhl W, Belyaev O, Kraus T, Witzigmann H, Hommann M, Klar E, Glanemann M, Gutt C, Manger T, Kraemling HJ, Kalff JC, Glowka TR, Nuessler NC, Ritz JP, Padberg W, Kroesen AJ, Stier A, Lorenz D, Bechstein WO, Oldhafer KJ, Eisold S, Troebs U, Reith HB, Schumacher FJ, Wagler E, Farkas S, Klammer F, Schwarzbach M, Niedergethmann M, Runkel N, Piso P, Lorenz EPM, Moench C, Bieck S, Grützmann R, Brunner M, Friess H (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Book Volume: 43

Pages Range: 175-182

Journal Issue: 1

DOI: 10.1007/s00268-018-4751-2

Abstract

BackgroundENETS guidelines recommend parenchyma-sparing procedures without formal lymphadenectomy, ideally with a minimally invasive laparoscopic approach for sporadic small pNENs (2cm). Non-functioning (NF) small pNENs can also be observed. The aim of the study was to evaluate how these recommendations are implemented in the German surgical community.MethodsData from the prospective StuDoQ|Pancreas registry of the German Society of General and Visceral Surgery were analyzed regarding patient's demographics, tumor characteristics, surgical procedures, histology and perioperative outcomes.ResultsEighty-four (29.2%) of 287 patients had sporadic pNENs 2cm. Forty-three (51.2%) patients were male, and the mean age at diagnosis was 58.815.6years. Twenty-five (29.8%) pNENs were located in the pancreatic head. The diagnosis pNEN was preoperatively established in 53 (65%) of 84 patients. Sixty-two (73.8%) patients had formal pancreatic resections, including partial pancreaticoduodenectomy or total pancreatectomy (21.4%). Only 22 (26.2%) patients underwent parenchyma-sparing resections and 23 (27.4%) patients had minimally invasive procedures. A lymphadenectomy was performed in 63 (75.4%) patients, and lymph node metastases were diagnosed in 6 (7.2%) patients. Eighty-two (97.7%) patients had an R0 resection. Sixty (72%) tumors were classified G1, 24 (28%) tumors G2. Twenty-seven (32.2%) of 84 patients had postoperative relevant Clavien-Dindo grade 3 complications. Thirty- and 90-day mortalities were 2.4% and 3.6%.ConclusionsENETS guidelines for surgery of small pNENs are yet not well accepted in the German surgical community, since the rate of formal resections with standard lymphadenectomy is high and the minimally invasive approach is underused. The attitude to operate small NF tumors seems to be rather aggressive.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Münster Germany (DE) Asklepios Klinik Altona Germany (DE) Klinikum Augsburg Germany (DE) Universitätsklinikum Bonn Germany (DE) Städtisches Klinikum München Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) Germany (DE) Evangelisches Krankenhaus Düsseldorf Germany (DE) Krankenhaus Nordwest Germany (DE) Alfried Krupp Krankenhaus Germany (DE) HELIOS Kliniken Germany (DE) Kreiskrankenhaus Delitzsch & Eilenburg Germany (DE) Philipps-Universität Marburg Germany (DE) Universitätsklinikum des Saarlandes (UKS) Germany (DE) SRH Wald-Klinikum Gera Germany (DE) Krankenhaus Dresden-Friedrichstadt, Städtisches Klinikum Germany (DE) Krankenhaus Barmherzige Brüder Germany (DE) Sana Klinikum Offenbach Germany (DE) Katholisches Klinikum Bochum (St. Josef- und St. Elisabeth-Hospital gGmbH) Germany (DE) Universitätsklinikum Göttingen Germany (DE) Universitätsklinikum Mannheim Germany (DE) Universitätsklinikum Freiburg Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) Schwarzwald-Baar Klinikum Germany (DE) Katharinenhospital Stuttgart Germany (DE) Zentralklinikum Bad Berka Germany (DE) Universitätsklinikum Jena Germany (DE) Klinikum Memmingen Germany (DE) Krankenhaus Porz am Rhein Germany (DE) Universitätsmedizin Rostock Germany (DE) St. Franziskus-Hospital Münster Germany (DE) Agaplesion Diakonie Kliniken Kassel Germany (DE) Klinikum der Universität München (Großhadern und Innenstadt) Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Sana Kliniken Lübeck GmbH Germany (DE) Universitätsklinikum Würzburg Germany (DE) Katholisches Klinikum Oberhausen GmbH Germany (DE) Westpfalz-Klinikum Germany (DE) Alexianer St. Hedwig Kliniken Berlin GmbH Germany (DE) Technische Universität München (TUM) Germany (DE)

How to cite

APA:

Mintziras, I., Keck, T., Werner, J., Fichtner-Feigl, S., Wittel, U., Senninger, N.,... Friess, H. (2019). Implementation of Current ENETS Guidelines for Surgery of Small (2cm) Pancreatic Neuroendocrine Neoplasms in the German Surgical Community: An Analysis of the Prospective DGAV StuDoQ|Pancreas Registry. World Journal of Surgery, 43(1), 175-182. https://doi.org/10.1007/s00268-018-4751-2

MLA:

Mintziras, Ioannis, et al. "Implementation of Current ENETS Guidelines for Surgery of Small (2cm) Pancreatic Neuroendocrine Neoplasms in the German Surgical Community: An Analysis of the Prospective DGAV StuDoQ|Pancreas Registry." World Journal of Surgery 43.1 (2019): 175-182.

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