Female sex is associated with improved outcomes after surgery for pancreatic neuroendocrine neoplasms
BACKGROUND: Sex-related differences in oncologic outcomes are well established in pancreatic adenocarcinoma, but evidence in pancreatic neuroendocrine neoplasms (pNEN) remains limited. This study analyses the association of female sex and pre-menopausal status with perioperative outcomes and long-te...
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| Hauptverfasser: | , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
13 June 2026
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| In: |
European journal of surgical oncology
Year: 2026, Jahrgang: 52, Heft: 8, Pages: 1-7 |
| ISSN: | 1532-2157 |
| DOI: | 10.1016/j.ejso.2026.111954 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ejso.2026.111954
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| Verfasserangaben: | Fabiola A. Bechtiger, Jörg Kaiser, Ingmar F. Rompen, Ulf Hinz, Magdalena Lewosinska, Carl-Stephan Leonhardt, Mohammed Al-Saeedi, Martin Loos, Markus W. Büchler, Thomas Hank |
| Zusammenfassung: | BACKGROUND: Sex-related differences in oncologic outcomes are well established in pancreatic adenocarcinoma, but evidence in pancreatic neuroendocrine neoplasms (pNEN) remains limited. This study analyses the association of female sex and pre-menopausal status with perioperative outcomes and long-term survival after resection of non-functioning pNEN. - METHODS: Patients who underwent pancreatic surgery for pNEN at Heidelberg University Hospital between 2001 and 2023 were analyzed. Outcomes included perioperative morbidity, disease-free survival (DFS) and overall survival (OS). Subgroups were stratified by age (<50, 50-65, >65 years) as a surrogate for menopausal status. Survival was estimated by Kaplan-Meier analysis and Cox regression was used to evaluate associations with OS. - RESULTS: A total of 591 patients were included, of whom 257 (43.5%) were female. Age and ASA class were similar between sexes, while females had a lower BMI (24.6 vs 26.3kg/m2, p<0.001). Resection types did not differ, but operative time was shorter in females (240 vs 265min, p=0.003). Major complications were comparable (CDC ≥3a: 30.7% vs 34.1%, p=0.426), whereas severe complications (CDC ≥3b) occurred less often in females (9.7% vs 15.3%, p=0.048). TNM stage was similar, although males had more G3 tumors (15.9% vs 8.2%, p=0.019). Females had longer DFS (129.4 vs 75.5 months, p=0.006) and increased OS (5-year: 85.7% vs 70.5%; 10-year: 72.2% vs 61.1%; p=0.002). This effect was driven by patients <50 years, indicating a pre-menopausal survival advantage, as females had markedly better outcomes than age-matched males (p=0.022). On multivariable cox-regression analysis, female sex, age, grading and M-status remained independently associated with OS. - CONCLUSIONS: Female sex is associated with improved perioperative outcomes and increased long-term survival after resection in non-functioning pNEN. The survival benefit was largely determined by pre-menopausal patients, highlighting sex and menopausal status as relevant prognostic factors. |
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| Beschreibung: | Gesehen am 11.09.2026 |
| Beschreibung: | Online Resource |
| ISSN: | 1532-2157 |
| DOI: | 10.1016/j.ejso.2026.111954 |