Elina Peltola, Päivi Hannula, Heini Huhtala, et al., “Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland,” International Journal of Endocrinology, vol. 2018, Article ID 2059481, 10 pages, 2018. https://doi.org/10.1155/2018/2059481
Characteristics and outcomes of 79 patients with an insulinoma : a nationwide retrospective study in Finland
|Author:||Peltola, Elina1,2; Hannula, Päivi3; Huhtala, Heini4;|
1Faculty of Medicine and Life Sciences, University of Tampere, Finland
2Division of Internal Medicine, Seinäjoki Central Hospital, Finland
3Endocrinology, Department of Internal Medicine, Tampere University Hospital, Finland
4Faculty of Social Sciences, University of Tampere, Finland
5Fimlab Laboratories, Pathology Department, Tampere University Hospital, Finland
6Päijät-Häme Joint Authority for Health and Wellbeing, Finland
7Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Finland
8Endocrinology, Abdominal Center, Helsinki University Hospital, Finland
9Endocrinology, Abdominal Center, University of Helsinki, Finland
10Pathology, HUSLAB Helsinki University Hospital, Finland
11Pathology, University of Helsinki, Finland
12Abdominal Center, Helsinki University Hospital, Finland
13Faculty of Medicine, University of Turku, Finland
14Endocrinology, Department of Internal Medicine, Turku University Hospital, Finland
15Department of Pathology, Turku University Hospital, Finland
16Faculty of Health Sciences, School of Medicine, University of Eastern Finland, Finland
17Department of Medicine, Kuopio University Hospital, Finland
18Department of Clinical Pathology, Kuopio University Hospital, Finland
19Faculty of Medicine, University of Oulu, Finland
20Endocrinology, Oulu University Hospital, Finland
21Research Unit of Cancer and Translational Medicine, Department of Pathology, University of Oulu, Finland
22Department of Pathology, Oulu University Hospital, Finland
|Online Access:||PDF Full Text (PDF, 1.5 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2019070122415
|Publish Date:|| 2019-07-01
Objective: Insulinomas are rare pancreatic tumours. Population-based data on their incidence, clinical picture, diagnosis, and treatment are almost nonexistent. The aim of this study was to clarify these aspects in a nationwide cohort of insulinoma patients diagnosed during three decades.
Design and Methods: Retrospective analysis on all adult patients diagnosed with insulinoma in Finland during 1980–2010.
Results: Retrospective analysis on all adult patients diagnosed with insulinoma in Finland during 1980–2010. Results. Seventy-nine patients were diagnosed with insulinoma over the research period. The median follow-up from diagnosis to last control visit was one (min 0, max 31) year. The incidence increased from 0.5/million/year in the 1980s to 0.9/million/year in the 2000s (p = 0 002). The median diagnostic delay was 13 months and did not change over the study period. The mean age at diagnosis was 52 (SD 16) years. The overall imaging sensitivity improved from 39% in the 1980s to 98% in the 2000s (p < 0 001). Seventy-one (90%) of the patients underwent surgery with a curative aim, two (3%) had palliative surgery, and 6 (8%) were inoperable. There were no significant differences in the types of surgical procedures between the 1980s, 1990s, and 2000s; tumour enucleations comprised 43% of the operations, distal pancreatic resections 45%, and pancreaticoduodenectomies 12%, over the whole study period. Of the patients who underwent surgery with a curative aim, 89% had a full recovery. Postoperative complications occurred in half of the patients, but postoperative mortality was rare..
Conclusions: The incidence of insulinomas has increased during the past three decades. Despite the improved diagnostic options, diagnostic delay has remained unchanged. To shorten the delay, clinicians should be informed and alert to consider the possibility of hypoglycemia and insulinoma, when symptomatic attacks are investigated in different sectors of the healthcare system. Developing the surgical treatment is another major target, in order to lower the overall complication rate, without compromising the high cure rate of insulinomas.
International journal of endocrinology
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3121 General medicine, internal medicine and other clinical medicine
This work was financially supported by the Competitive Research Funding of the Special Responsibility Area of Tampere University Hospital (9U012) and by the Finnish Medical Foundation.
Copyright © 2018 Elina Peltola et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.