Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland
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...
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2018-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2018/2059481 |
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| author | Elina Peltola Päivi Hannula Heini Huhtala Saara Metso Ulla Kiviniemi Martine Vornanen Juhani Sand Johanna Laukkarinen Mirja Tiikkainen Camilla Schalin-Jäntti Johanna Arola Jukka Sirén Antti Piiroinen Minna Soinio Pirjo Nuutila Mirva Söderström Hanna Hämäläinen Leena Moilanen David Laaksonen Elina Pirinen Fia Sundelin Tapani Ebeling Pasi Salmela Markus J. Mäkinen Pia Jaatinen |
| author_facet | Elina Peltola Päivi Hannula Heini Huhtala Saara Metso Ulla Kiviniemi Martine Vornanen Juhani Sand Johanna Laukkarinen Mirja Tiikkainen Camilla Schalin-Jäntti Johanna Arola Jukka Sirén Antti Piiroinen Minna Soinio Pirjo Nuutila Mirva Söderström Hanna Hämäläinen Leena Moilanen David Laaksonen Elina Pirinen Fia Sundelin Tapani Ebeling Pasi Salmela Markus J. Mäkinen Pia Jaatinen |
| author_sort | Elina Peltola |
| collection | DOAJ |
| description | 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. 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. |
| format | Article |
| id | doaj-art-bd23361b5b8040b39a0ae372dac907e2 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-bd23361b5b8040b39a0ae372dac907e22025-02-03T06:12:08ZengWileyInternational Journal of Endocrinology1687-83371687-83452018-01-01201810.1155/2018/20594812059481Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in FinlandElina Peltola0Päivi Hannula1Heini Huhtala2Saara Metso3Ulla Kiviniemi4Martine Vornanen5Juhani Sand6Johanna Laukkarinen7Mirja Tiikkainen8Camilla Schalin-Jäntti9Johanna Arola10Jukka Sirén11Antti Piiroinen12Minna Soinio13Pirjo Nuutila14Mirva Söderström15Hanna Hämäläinen16Leena Moilanen17David Laaksonen18Elina Pirinen19Fia Sundelin20Tapani Ebeling21Pasi Salmela22Markus J. Mäkinen23Pia Jaatinen24Faculty of Medicine and Life Sciences, University of Tampere, FinlandEndocrinology, Department of Internal Medicine, Tampere University Hospital, FinlandFaculty of Social Sciences, University of Tampere, FinlandEndocrinology, Department of Internal Medicine, Tampere University Hospital, FinlandEndocrinology, Department of Internal Medicine, Tampere University Hospital, FinlandFimlab Laboratories, Pathology Department, Tampere University Hospital, FinlandPäijät-Häme Joint Authority for Health and Wellbeing, FinlandFaculty of Medicine and Life Sciences, University of Tampere, FinlandEndocrinology, Abdominal Center, Helsinki University Hospital, FinlandEndocrinology, Abdominal Center, Helsinki University Hospital, FinlandPathology, HUSLAB Helsinki University Hospital, FinlandAbdominal Center, Helsinki University Hospital, FinlandFaculty of Medicine, University of Turku, FinlandEndocrinology, Department of Internal Medicine, Turku University Hospital, FinlandFaculty of Medicine, University of Turku, FinlandDepartment of Pathology, Turku University Hospital, FinlandFaculty of Health Sciences, School of Medicine, University of Eastern Finland, FinlandDepartment of Medicine, Kuopio University Hospital, FinlandDepartment of Medicine, Kuopio University Hospital, FinlandDepartment of Clinical Pathology, Kuopio University Hospital, FinlandFaculty of Medicine, University of Oulu, FinlandFaculty of Medicine, University of Oulu, FinlandEndocrinology, Oulu University Hospital, FinlandResearch Unit of Cancer and Translational Medicine, Department of Pathology, University of Oulu, FinlandFaculty of Medicine and Life Sciences, University of Tampere, FinlandObjective. 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. 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.http://dx.doi.org/10.1155/2018/2059481 |
| spellingShingle | Elina Peltola Päivi Hannula Heini Huhtala Saara Metso Ulla Kiviniemi Martine Vornanen Juhani Sand Johanna Laukkarinen Mirja Tiikkainen Camilla Schalin-Jäntti Johanna Arola Jukka Sirén Antti Piiroinen Minna Soinio Pirjo Nuutila Mirva Söderström Hanna Hämäläinen Leena Moilanen David Laaksonen Elina Pirinen Fia Sundelin Tapani Ebeling Pasi Salmela Markus J. Mäkinen Pia Jaatinen Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland International Journal of Endocrinology |
| title | Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland |
| title_full | Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland |
| title_fullStr | Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland |
| title_full_unstemmed | Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland |
| title_short | Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland |
| title_sort | characteristics and outcomes of 79 patients with an insulinoma a nationwide retrospective study in finland |
| url | http://dx.doi.org/10.1155/2018/2059481 |
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