267 Outcomes Following Surgery for Pancreatic Neuroendocrine Tumours: A 14-Year Tertiary-Centre Experience

Abstract Aim To evaluate survival outcomes and recurrence patterns following curative-intent resection of pancreatic neuroendocrine tumours at a UK tertiary centre, and to identify prognostic clinicopathological factors. Method Patients undergoing curative-intent surgical resection for PNETs between August 2010 and March 2024 were retrospectively reviewed. Data included demographics, histopathology, recurrence, and survival outcomes. Results Eighty-six patients were included, with a median age of 61.5 years (IQR: 50–71) and equal sex distribution. Most tumours were solitary (88.4%), located in the pancreatic tail (57%), with distal pancreatectomy in 75% of cases. Median tumour size was 25 mm (IQR: 13–40). Lymph node metastases were seen in 23.3%, and R0 resection achieved in 67%. Tumours were predominantly WHO grade 1 (65.1%) or grade 2 (26.7%). Postoperative morbidity occurred in 37.2%, and mortality was 15%. Recurrence occurred in 13.95%, mainly as distant metastases (58.3%), with a median interval of 36.3 months. Five-year overall survival (OS) was 83.0%, with median OS and disease-free survival (DFS) of 143.3 and 147.0 months, respectively. Multivariate analysis showed shorter DFS was independently associated with larger tumour size (p = 0.009), higher grade (p = 0.006), male sex (p = 0.039), vascular (p = 0.003) and perineural invasion (p = 0.042), and nodal metastases (p = 0.015). OS was significantly influenced by Charlson Comorbidity Index (p < 0.001) and tumour grade (p = 0.025). Conclusions PNETs have excellent long-term survival following resection. However, adverse pathological features are linked to increased risk of recurrence and poorer prognosis.