PWE-214 The management of incidentally diagnosed pancreatic neuroendocrine lesions: a new tool to evaluate risk of malignancy

Introduction The regular use of CT scanning has increased the number of incidentally diagnosed, small, asymptomatic pancreatic neuroendocrine tumours (PNETs). Given their uncertain natural history, they pose a management dilemma. Whilst resection offers curative outcomes, the risks of surgery such as with a Whipple–s procedure have led many to adopt surveillance strategies. Patient selection criteria for surveillance lack definitive evidence. Diameter Method The notes of 233 patients with PNETs of all stages were reviewed for pathology reports. Tumours were defined as malignant if displaying local invasion, nodal involvement or distant metastasis (metachronous or synchronous). Predictors of malignancy were considered using logistic regression. Results Malignant characteristics were shown to correlate with tumour diameter (r 2 >0.8). However, of 68 tumours 164 tumours displayed malignant characteristics, 64 had no evidence of malignancy and data was unavailable for 5. Significant univariate predictors of malignancy included diameter (mean 21mm vs. 47mm, p Conclusion PNETs Disclosure of interest None Declared. Reference Cherenfant, J. et al . Predicting aggressive behavior in nonfunctioning pancreatic neuroendocrine tumors. Surgery 2013; 154 :785–91; discussion 791–793