University of Oulu

Peltola, E., Hannula, P., Huhtala, H., Metso, S., Sand, J., Laukkarinen, J., Tiikkainen, M., Sirén, J., Soinio, M., Nuutila, P., Moilanen, L., Laaksonen, D. E., Ebeling, T., Arola, J., Schalin-Jäntti, C., & Jaatinen, P. (2021). Long-term morbidity and mortality in patients diagnosed with an insulinoma, European Journal of Endocrinology, 185(4), 577-586. Retrieved Mar 24, 2022, from https://eje.bioscientifica.com/view/journals/eje/185/4/EJE-21-0230.xml

Long-term morbidity and mortality in patients diagnosed with an insulinoma

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Author: Peltola, Elina1,2; Hannula, Päivi1,3; Huhtala, Heini4;
Organizations: 1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
2Division of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
3Endocrinology, Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
4Faculty of Social Sciences, Tampere University, Tampere, Finland
5Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
6Endocrinology, Abdominal Center
7Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
8Surgery, Abdominal Center, University of Helsinki, Helsinki, Finland
9Department of Endocrinology
10Department of Endocrinology, Division of Medicine, Turku University Hospital, Turku, Finland
11Turku PET Centre, University of Turku, Turku, Finland
12Department of Medicine, Kuopio University Hospital, Kuopio, Finland
13Faculty of Medicine, University of Oulu, Oulu, Finland
14Endocrinology, Department of Medicine, Oulu University Hospital, Oulu, Finland
15Pathology, HUSLAB, Helsinki University Hospital, Helsinki, Finland
16Pathology, University of Helsinki, Helsinki, Finland
17Endocrinology, Abdominal Center, University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2022032425060
Language: English
Published: Bioscientifica, 2021
Publish Date: 2022-03-24
Description:

Abstract

Objective: Insulinomas are rare functional pancreatic neuroendocrine tumours. As previous data on the long-term prognosis of insulinoma patients are scarce, we studied the morbidity and mortality in the Finnish insulinoma cohort.

Design: Retrospective cohort study.

Methods: Incidence of endocrine, cardiovascular, gastrointestinal and psychiatric disorders, and cancers was compared in all the patients diagnosed with an insulinoma in Finland during 1980–2010 (n = 79, including two patients with multiple endocrine neoplasia type 1 syndrome), vs 316 matched controls, using the Mantel–Haenszel method. Overall survival was analysed with Kaplan–Meier and Cox regression analyses

Results: The median length of follow-up was 10.7 years for the patients and 12.2 years for the controls. The long-term incidence of atrial fibrillation (rate ratio (RR): 2.07 (95% CI: 1.02–4.22)), intestinal obstruction (18.65 (2.09–166.86)), and possibly breast (4.46 (1.29–15.39) and kidney cancers (RR not applicable) was increased among insulinoma patients vs controls, P  < 0.05 for all comparisons. Endocrine disorders and pancreatic diseases were more frequent in the patients during the first year after insulinoma diagnosis, but not later on. The survival of patients with a non-metastatic insulinoma (n = 70) was similar to that of controls, but for patients with distant metastases (n = 9), the survival was significantly impaired (median 3.4 years).

Conclusions: The long-term prognosis of patients with a non-metastatic insulinoma is similar to the general population, except for an increased incidence of atrial fibrillation, intestinal obstruction, and possibly breast and kidney cancers. These results need to be confirmed in future studies. Metastatic insulinomas entail a markedly decreased survival.

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Series: European journal of endocrinology
ISSN: 0804-4643
ISSN-E: 1479-683X
ISSN-L: 0804-4643
Volume: 185
Issue: 4
Pages: 577 - 586
DOI: 10.1530/EJE-21-0230
OADOI: https://oadoi.org/10.1530/EJE-21-0230
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Subjects:
Funding: This work was supported by the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (grant numbers 9U012, 5900/3225, 6000/3231; to E P, P J), the Medical Research Fund of Seinäjoki Central Hospital (grant numbers 1717/6043, 1717/6080; to E P, P J), the Seinäjoki City and Tampere University Research Funds (not numbered; to E P, P J), the Helsinki University Hospital Research Funds (grant number TYH2019254; to C S-J) and Finska Läkaresällskapet (not numbered; to C S-J).
Copyright information: © 2021 The authors. Published by Bioscientifica Ltd. This work is licensed under a Creative Commons Attribution 4.0 International License.
  https://creativecommons.org/licenses/by/4.0/