{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:58:10Z","timestamp":1789095490102,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Pancreatic neuroendocrine tumors (pNETs) in patients with hereditary cancer syndromes are typically multifocal. In contrast, sporadic pNETs are usually unifocal and the incidence of multifocal sporadic pNETs is unknown. The primary aim of this study was to investigate the incidence of multifocality in sporadic pNETs and any associated effect on recurrence risk and survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients who underwent resection of pNETs at Mayo Clinic from 2000 to 2019 were identified and clinical data were obtained from medical records. Syndromic disease was defined as pNETs arising in the setting of a hereditary cancer syndrome. Statistical comparisons were made using\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      , Fisher's exact, and Kruskal\u2013Wallis tests and survival was assessed using the Kaplan\u2013Meier method.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six hundred and sixty\u2010one patients with sporadic pNETs and fifty\u2010nine with syndromic pNETs were identified. Multifocal disease was present in 4.8% of sporadic patients and 84.7% of syndromic patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Within patients with sporadic pNETs, clinicopathologic features and recurrence\u2010free and overall survival were similar between patients with unifocal and multifocal disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Multifocal sporadic pNETs are rare and multifocality is not associated with worse survival or increased recurrence risk. Patients with multifocal sporadic pNETs can likely be safely managed with a combination of resection and observation as indicated for each tumor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.26618","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T13:35:14Z","timestamp":1627306514000},"page":"1077-1084","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Multifocality is not associated with worse survival in sporadic pancreatic neuroendocrine tumors"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-2769","authenticated-orcid":false,"given":"Hallbera","family":"Gudmundsdottir","sequence":"first","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8686-4867","authenticated-orcid":false,"given":"Rondell P.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6931-242X","authenticated-orcid":false,"given":"Mohamad B.","family":"Sonbol","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Mayo Clinic Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory L.","family":"Smoot","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Truty","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Kendrick","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Nagorney","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1140-003X","authenticated-orcid":false,"given":"Elizabeth B.","family":"Habermann","sequence":"additional","affiliation":[{"name":"Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8460-1257","authenticated-orcid":false,"given":"Thorvardur R.","family":"Halfdanarson","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean P.","family":"Cleary","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdn351"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2020.38.4_suppl.629"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2008-0259"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.10.013"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-2604"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001454"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10312"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23648"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000511791"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-011-0828-1"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-05-4184"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-10-0037"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017-00372"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002191"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(15)00043-1"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-017-3586-8"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000000911"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-1230"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2010.175"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2013.08.001"},{"key":"e_1_2_7_22_1","first-page":"172","article-title":"National Institutes of Health Consensus Development Conference statement: neurofibromatosis","volume":"1","author":"National Institutes of Health","year":"1988","journal-title":"Neurofibromatosis"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-014-3018-3"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24258"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001597"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2014.147"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3410\/M2-14"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.26618","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jso.26618","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.26618","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T03:28:05Z","timestamp":1693193285000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.26618"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,26]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1002\/jso.26618"],"URL":"https:\/\/doi.org\/10.1002\/jso.26618","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,26]]},"assertion":[{"value":"2021-05-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}