胃泌素瘤的唯一治愈治疗是完全切除，但其手术管理仍然存在争议，散发性非转移性胃泌素瘤的预后因素知之甚少。这是一项回顾性研究，包括2000年至2020年在15家医院接受非转移性散发性胃泌素瘤择期手术的所有患者。主要和次要结果是总生存率和无病生存率的预测因素。总共包括108名患者，其中68名（63%）为十二指肠型，19名（18%）为胰腺型，21名（19%）为原发性淋巴结胃泌素瘤，临床表现没有明显差异。在68例十二指肠胃泌素瘤中，26%（n = 18）接受胰十二指肠切除术（PD），74%（n = 50）接受十二指肠切开术，切除十二指肠壁肿瘤和淋巴清扫（DUODX + LN）。总体而言，中位总生存期是173个月，5年总生存率为94％，没有发现预测因素。中位无病生存期为93个月，5年无病生存率为63％。肿瘤大小> 2 cm（P = .00001）、分级（P = .00001）和胰腺肿瘤位置（P = .0001）是复发的预测因素；然而，在多因素分析中，只有肿瘤大小> 2 cm（P = .005）和分级（P = .013）是复发的独立预测因素。年龄、性别、术前胃泌素水平、淋巴清扫<10个切除淋巴结以及手术标本上的转移性淋巴结不是复发的预测因素。对于十二指肠型胃泌素瘤，手术方式（PD与DUODX + LN）对总生存率和无病生存率没有显着影响。散发性非转移性胃泌素瘤具有优异的总体生存率。复发频繁并受肿瘤大小和分级的影响。关于散发性十二指肠型胃泌素瘤，十二指肠切开术切除十二指肠壁肿瘤并行淋巴清扫，在PD没有明显肿瘤学优势的情况下可被视为有效的手术选择。版权所有©2023 Elsevier Inc.。保留所有权利。

The only curative treatment of gastrinoma is complete resection, but its surgical management remains controversial and prognostic factors of sporadic nonmetastatic gastrinoma are poorly known.This was a retrospective study including all patients who underwent elective surgery for nonmetastatic sporadic gastrinoma between 2000 and 2020 in 15 hospitals. The primary and secondary outcomes were overall survival and disease-free survival predictive factors.In total, 108 patients were included, of which 68 (63%) were duodenal, 19 (18%) pancreatic, and 21 (19%) primary lymph node gastrinomas, with no major difference in clinical presentation. Among the 68 duodenal gastrinomas, 26% (n = 18) underwent pancreaticoduodenectomy (PD) and 74% (n = 50) underwent duodenotomy with the excision of duodenal wall tumors and lymphadenectomy (DUODX + LN). Overall, the median overall survival was 173 months, and the 5-year overall survival was 94%, with no predictive factors identified. The median disease-free survival was 93 months, and the 5-year disease-free survival was 63%. Tumor size >2 cm (P = .00001), grade (P = .00001), and pancreatic tumor location (P = .0001) were predictive factors of recurrence; however, in multivariate analysis, only tumor size >2 cm (P = .005) and grade (P = .013) were independent predictors of recurrence. Age, sex, preoperative gastrin level, lymphadenectomy <10 resected lymph nodes, and metastatic lymph nodes on surgical specimens were not predictors of recurrence. For duodenal gastrinomas, surgical procedures (PD versus DUODX + LN) did not have a significant effect on overall survival and disease-free survival.Sporadic nonmetastatic gastrinomas had an excellent overall survival. Recurrence is frequent and influenced by tumor size and grade. Regarding sporadic duodenal gastrinoma, duodenotomy with excision of duodenal wall tumors with lymphadenectomy could be considered a valid surgical option, in the absence of clear oncologic superiority of PD.Copyright © 2023 Elsevier Inc. All rights reserved.