{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T14:04:46Z","timestamp":1794233086561,"version":"4.9.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Incidence of endocrine, cardiovascular, gastrointestinal and psychiatric disorders, and cancers was compared in all the patients diagnosed with an insulinoma in Finland during 1980\u20132010 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200979, including two patients with multiple endocrine neoplasia type 1 syndrome), vs 316 matched controls, using the Mantel\u2013Haenszel method. Overall survival was analysed with Kaplan\u2013Meier and Cox regression analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u20134.22)), intestinal obstruction (18.65 (2.09\u2013166.86)), and possibly breast (4.46 (1.29\u201315.39) and kidney cancers (RR not applicable) was increased among insulinoma patients vs controls,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009 &lt; 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                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200970) was similar to that of controls, but for patients with distant metastases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099), the survival was significantly impaired (median 3.4 years).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/eje-21-0230","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T11:38:43Z","timestamp":1628595523000},"page":"577-586","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-7","source":"Crossref","is-referenced-by-count":24,"title":["Long-term morbidity and mortality in patients diagnosed with an insulinoma"],"prefix":"10.1093","volume":"185","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3359-7109","authenticated-orcid":true,"given":"Elina","family":"Peltola","sequence":"first","affiliation":[{"name":"1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland"},{"name":"2Division of Internal Medicine, Sein\u00e4joki Central Hospital, Sein\u00e4joki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"Hannula","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland"},{"name":"3Endocrinology, Department of Internal Medicine, Tampere University Hospital, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[{"name":"4Faculty of Social Sciences, Tampere University, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saara","family":"Metso","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland"},{"name":"3Endocrinology, Department of Internal Medicine, Tampere University Hospital, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhani","family":"Sand","sequence":"additional","affiliation":[{"name":"5Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Laukkarinen","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland"},{"name":"5Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirja","family":"Tiikkainen","sequence":"additional","affiliation":[{"name":"6Endocrinology, Abdominal Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukka","family":"Sir\u00e9n","sequence":"additional","affiliation":[{"name":"7Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland"},{"name":"8Surgery, Abdominal Center, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minna","family":"Soinio","sequence":"additional","affiliation":[{"name":"9Department of Endocrinology, Division of Medicine, Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirjo","family":"Nuutila","sequence":"additional","affiliation":[{"name":"10Department of Endocrinology, Division of Medicine, Turku University Hospital, Turku, Finland"},{"name":"11Turku PET Centre, University of Turku, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Moilanen","sequence":"additional","affiliation":[{"name":"12Department of Medicine, Kuopio University Hospital, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E","family":"Laaksonen","sequence":"additional","affiliation":[{"name":"12Department of Medicine, Kuopio University Hospital, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tapani","family":"Ebeling","sequence":"additional","affiliation":[{"name":"13Faculty of Medicine, University of Oulu, Oulu, Finland"},{"name":"14Endocrinology, Department of Medicine, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Arola","sequence":"additional","affiliation":[{"name":"15Pathology, HUSLAB, Helsinki University Hospital, Helsinki, Finland"},{"name":"16Pathology, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Schalin-J\u00e4ntti","sequence":"additional","affiliation":[{"name":"6Endocrinology, Abdominal Center"},{"name":"17Endocrinology, Abdominal Center, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8693-3498","authenticated-orcid":true,"given":"Pia","family":"Jaatinen","sequence":"additional","affiliation":[{"name":"1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland"},{"name":"2Division of Internal Medicine, Sein\u00e4joki Central Hospital, Sein\u00e4joki, Finland"},{"name":"3Endocrinology, Department of Internal Medicine, Tampere University Hospital, Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","container-title":["European Journal of 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