Prognostic factors of non-functioning pancreatic neuroendocrine neoplasms after curative surgery and risk factors for liver recurrence

Abstract Purpose This study aimed to identify the prognostic factors of non-functioning pancreatic neuroendocrine neoplasms (NF-PNENs) after curative surgery and evaluate the risk factors for liver recurrence in patients with NF-PNENs. Methods We retrospectively analysed clinicopathological data from 1993 to 2021 to determine predictors of poor overall survival (OS) and disease-free survival (DFS) and risk factors for liver recurrence after curative surgery in patients with NF-PNENs. Independent factors associated with survival and liver recurrence were identified using multivariate analysis. Results Of the 107 consecutive patients with pancreatic neuroendocrine neoplasms who underwent surgical resection, 78 who underwent curative surgery were eligible for this study. The median postoperative follow-up time was 58.1 months. The 5-year OS and DFS were 90.7% and 86.8%, respectively. Eight (10%) patients had imaging findings of recurrence, with liver recurrence being the most frequent (n = 7). In multivariate analysis, lymph node metastasis (LNM) ( P = 0.026) was the only independent predictor of poor OS and DFS. Moreover, LNM ( P = 0.036) was the only independent risk factor for liver recurrence. Conclusion LNM was independently associated with poor prognosis in patients with NF-PNENs after curative surgery. LNM was the only independent risk factor for liver recurrence, which is a haematogenous metastasis. Therefore, systemic treatment may help prevent distant metastases and prolong the prognosis.