Pancreatic neuroendocrine tumors usually consist of all the tumors related to hormone-producing cells of the pancreas, the commonest of them are beta cell tumor known as insulinoma. Due to the high incidence of insulinoma, these are also known as islet cell tumors.
Life Expectancy Of Someone With Pancreatic Neuroendocrine Tumor
When comparing the pancreatic exocrine and neuroendocrine tumors then the neuroendocrine tumors have higher life expectancy than the pancreatic exocrine tumors. This is because the neuroendocrine in tumors of pancreas are very slow-growing and have very low metastatic potential in comparison to exocrine tumors which are highly metastatic at the growth is also very fast. The malignancy rate and the metastatic potential are also known to be lesser in neuroendocrine tumors as compared to exocrine tumors of the pancreas but the systemic 5-year due to the production of additional hormones from the endocrine tumors also makes them very dangerous and troublesome to deal with. Continuous monitoring and medical therapy are required to control the hormonal symptoms and keep the tumor size in check.
The most common pancreatic endocrine tumor, insulinoma, is a benign tumor in more than 90% cases. The surgical resection has been found to be successful in more than 95% of the cases in insulinoma. These are usually hormone-producing tumors but the production is not too high to derange the systemic metabolism very frequently but they may produce symptoms like hypoglycemia as their presentation. It has the most successful rate of treatment and prognosis is very good. The life expectancy and the 5-year survival rate is more than 99%.
The second commonest tumor to be found as the pancreatic neuroendocrine tumor is gastrinoma. Gastrinoma is a malignant tumor with the highest malignancy rate amongst all other neuroendocrine tumors. More than 60% of the cases present with the malignancy itself and have a very poor prognosis. The involvement of liver in the metastasis is an important part of the prediction of life expectancy because the 5-year survival rate changes drastically from 90% or higher in non-liver metastasis to less than 20 to 30% in cases with liver metastasis. The worst ones are most commonly found in the head region of the pancreas which requires larger surgery to be performed known as Whipple’s operation. The surgery itself carries very high mortality and morbidity rate.
VIPoma’s are less commonly found tumors among other pancreatic neuroendocrine tumors but these also carry high metastatic potential. Along with the malignancies, the tumor also has got very problematic systemic symptoms like dehydration, electrolyte disturbance which is why this tumor is also known for causing pancreatic cholera. The systemic symptoms and malignancy make the life expectancy of this tumor hormone-producing and the 5-year survival rate is also very less.
The other two tumors left in the group of pancreatic neuroendocrine tumors known as somatostatinoma and glucagonoma also highly malignant tumors. The glucagonomas tend to be very large in size during their presentation making them very difficult for surgical resection whereas the somatostatinoma is a very highly malignant tumor with more than 80% of the cases already known to be malignant at their presentation. These tumors have less than 20% of the cases to be known to live more than 5 years and show very low and poor life expectancy.
The overall life expectancy of the pancreatic neuroendocrine tumors is good because of the treatment possible for the insulinomas. All the other neuroendocrine tumors have got poor life expectancy with a survival rate at 3 and 5 years nearly found to be equal to 60% and 40% respectively. In comparison to the exocrine pancreatic tumors, these tumors are known to have a good success rate in their treatment because of lower spreading potential and slower growth rate. The surgical treatment remains the mainstay in pancreatic neuroendocrine tumors. Adjuvant radiotherapy and chemotherapy have been tried to improve the prognosis of these tumors which has been successful to some extent but early detection of the tumor among the known hereditary cases is the key.