ArticleLangenbeck's archives of surgery2023
Changes in diagnosis and operative treatment of insulinoma over two decades.
Article in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Enucleation for insulinoma: consolidating evidence through systematic review and meta-analysis.Surgical endoscopy · 2025Pooled it
- Clinical Presentation and Outcomes of Insulinomas in Pediatric Patients.Hormone research in paediatrics · 2026Article
- Minimally Invasive Resection of Occult Insulinomas-Experience from an ENETS Centre of Excellence and Review of the Literature.Cancers · 2025Article
- Multicenter Study on the Clinical Characteristics, Diagnosis, and Treatment Outcomes of Insulinoma: Insights From 15 Medical Centres.Clinical endocrinology · 2025Article
- Recurrence of malignant insulinoma in the context of multiple endocrine neoplasia type 1: a case report.Journal of surgical case reports · 2025Article
- Enucleation for pancreatic neuroendocrine tumors: short- and long-term outcomes in a forty-year single-center experience.Endocrine oncology (Bristol, England) · 2025Article
- Insulinoma Unmasked: A Continuous Glucose Monitoring-Fueled Journey.Current oncology (Toronto, Ont.) · 2024Article
- Contemporary Approaches to the Surgical Management of Pancreatic Neuroendocrine Tumors.Cancers · 2024Review
- Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMost insulinomas are small solitary, benign neoplasms. Imaging and surgical techniques improved over the last 20 years. Thus, the aim of the present study was to analyze changes in diagnosis and surgery of insulinoma patients in a referral center over two decades.
methodsOperated patients with a histologically proven insulinoma were retrieved from a prospective database. Clinico-pathological characteristics and outcomes were retrospectively analyzed with regard to the time periods 2000-2010 (group 1) and 2011-2020 (group 2).
resultsSixty-one of 202 operated patients with pNEN had an insulinoma, 37 (61%) in group 1 and 24 (39%) in group 2. Of those 61 insulinomas, 49 (80%) were sporadic benign, 8 (13%) benign MEN1-associated insulinomas, and 4 (7%) sporadic malignant insulinomas. In 35 of 37 (95%) patients of group 1 and all patients of group 2, the insulinoma was preoperatively identified by imaging. The most sensitive imaging modality was endoscopic ultrasound (EUS) with correctly diagnosed and localized insulinomas in 89% of patients in group 1 and 100% in group 2. In group 1, significantly less patients were operated via minimally invasive approach compared to group 2 (19% (7/37) vs. 50% (12/24), p = 0.022). Enucleation was the most frequently performed operation (31 of 61, 51%), followed by distal resection (15 of 61, 25%) without significant differences between groups 1 and 2. The rate of relevant postoperative complications was not different between groups 1 and 2 (24% vs. 21%, p = 0.99). Two patients with benign insulinoma (1 out of each group) experienced disease recurrence and underwent a second resection. After a median follow-up of 134 (1-249) months, however, all 57 (100%) patients with benign insulinoma and 3 out of 4 patients with malignant insulinoma had no evidence of disease.
conclusionInsulinoma can be preoperatively localized in almost all patients, allowing for a minimally invasive, parenchyma-sparing resection in selected patients. The long-term cure rate is excellent.
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