Background. The incidence of small nonfunctioning neuroendocrine pancreatic tumors (NF-PNETs) has been increasing systematically in the last few decades. Surgical resection was once considered the treatment of choice but has been questioned in the direction of a more conservative approach for selected patients. Our aim was to analyze the outcome of surgical resection of small (≤3cm) NF-PNETs. Methods. We retrospectively evaluated 14 patients with sporadic NF-PNETs who underwent pancreatic resection. Data were collected from patients’ medical records. Results. Of the 14 patients included, 35.71% were men, and the average age was years. Comorbidities were present in 92.86% of the cases. The incidence of postoperative complications was 42.86%, the 30-day mortality was zero, and the length of follow-up was years. The results of pathological evaluations revealed WHO grade I in 42.86% of cases, II in 21.43%, and neuroendocrine carcinoma in 35.71%. The median tumor size was 1.85cm (range, 0.5–3cm), and 2 cases had synchronous metastasis. The median TNM stage was IIa (range, I–IV). The disease-free and patient survival rates were 87.5% and 100% at 3 years and 43.75% and 75% at 10 years, respectively. The tumor pathological grade was significantly higher in head tumors than body-tail tumors, but there were no differences with respect to tumor size and TNM staging. Conclusion. A surgical approach to treat small sporadic NF-PNETs is safe with low mortality and high patient survival. Based on these data, small pancreatic head tumors can be more aggressive, suggesting that surgical resection is still the best option to treat small nonfunctioning PNETS. Thus, conservative treatment should be indicated very cautiously for only cases with absolute contraindications for surgery.

中文翻译：

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小型非功能性神经内分泌胰腺肿瘤切除术后的结果见解

背景。在过去的几十年中，小型无功能性神经内分泌胰腺肿瘤（NF-PNETs）的发病率一直在系统地增加。手术切除曾经被认为是一种选择的治疗方法，但在针对某些患者采取更为保守的治疗方法的方向上受到了质疑。我们的目的是分析小的（≤3cm）NF-PNETs手术切除的结果。方法。我们回顾性评估了14例行胰腺切除术的散发性NF-PNETs患者。从患者的病历中收集数据。结果。在纳入的14例患者中，男性占35.71％，平均年龄为年。92.86％的病例存在合并症。术后并发症发生率为42.86％，30天死亡率为零，随访时间为年。病理评估结果显示，WHO I级病例占42.86％，II级病例占21.43％，神经内分泌癌病例占35.71％。中位肿瘤大小为1.85厘米（范围0.5–3厘米），其中2例发生了同步转移。TNM的中位分期为IIa（范围I–IV）。3年时无病生存率和患者生存率分别为10年和83.7％，患者生存率分别为43.75％和75％。头肿瘤的肿瘤病理学分级显着高于体尾肿瘤，但在肿瘤大小和TNM分期方面无差异。结论。外科手术治疗小型散发性NF-PNETs安全，死亡率低，患者生存率高。根据这些数据，胰头小瘤可能更具侵略性，这表明手术切除仍是治疗小型无功能PNETS的最佳选择。因此，仅在绝对有手术禁忌症的情况下，应非常谨慎地选择保守治疗。