Evidence map›Paper›PMID 37648887›Full record

ArticleAnnals of surgical oncology2023

Long-Term Outcomes of Tuberous Sclerosis Complex-Associated Non-functional Pancreatic Neuroendocrine Tumors: Should We Be More Conservative?

Shahrzad Arya, Marco Ventin, Martina Nebbia, Carlos Fernandez-Del Castillo, Gabriella Lionetto, Motaz Qadan, Keith D Lillemoe, Vikram Deshpande, Onofrio A Catalano, Elizabeth A Thiele and 1 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Tuberous sclerosis complex.Nature reviews. Disease primers · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Shahrzad Arya *Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Marco Ventin *Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Martina NebbiaDepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Carlos Fernandez-Del CastilloDepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Gabriella LionettoDepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Motaz QadanDepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Keith D LillemoeDepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Vikram DeshpandeDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Onofrio A CatalanoDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Elizabeth A ThieleHerscot Center for Tuberous Sclerosis Complex, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Cristina R FerroneDepartment of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Cristina.Ferrone@cshs.org.
Harvard University · USMassachusetts General Hospital · USCedars-Sinai Medical Center · US

Funding

Massachusetts General Hospital Internal Sundry fund
6 · The paper itself

Abstract

backgroundHereditary syndromes such as tuberous sclerosis complex (TSC) account for 10% of pancreatic neuroendocrine tumors (PNETs). Surgical intervention is the current standard of care for sporadic PNETs (spPNETs) that are >2 cm in size. We compared the long-term outcomes of resected TSC-PNETs with patients with spPNETs.

methodsWe conducted a retrospective review of perioperative data and outcomes of TSC-PNETs compared with spPNETs. Inclusion criteria involved selecting patients whose tumors were no larger than 5.1 cm, the maximum size observed in the TSC-PNET group.

resultsOf the 347 patients resected for PNETs, 14 were TSC-PNETs and 241 were non-functional spPNETs. The median age for the whole cohort was 56 years (interquartile range [IQR] 21.0) and 47% were female. The median follow-up was 103.8 months (95% confidence interval [CI] 89.2-118.6). Specifically, 14 patients with TSC-PNETs and 194 patients with spPNETs were included. Compared with spPNETs, patients with TSC-PNETs were operated on at a younger age (24.0 vs. 57.5 years; p < 0.001), were more frequently multifocal (28.5% vs. 0.0%; p < 0.001), were more likely to undergo minimally invasive operations (78.6% vs. 24.3%; p < 0.001), and had more R1 resections (28.6% vs. 5.7%; p = 0.006). Local and distant tumor recurrence was only observed in the spPNET group. The 5-year mortality rates for the spPNET and TSC-PNET groups were 6.2% and 0.0%, respectively. No PNET-related deaths were observed among TSC-PNETs.

conclusionNone of the TSC-PNET patients recurred after a median follow-up of 78.0 months. The risk-benefit of aggressive pancreatic operations in TSC-PNET patients is still unclear and our findings suggest a conservative approach should be considered.

Indexed as

Conservative TreatmentNeoplasm Recurrence, LocalNeuroendocrine TumorsPancreatectomyPancreatic NeoplasmsTuberous SclerosisAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RatemTOR inhibitorOutcomesPancreatic lesionPancreatic neuroendocrine tumorPNETTSCTuberous sclerosis complex syndrome

Identifiers

PMID37648887
PMCPMC10562497
OpenAlexW4386279671

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.