Evidence map›Paper›PMID 41520322›Full record

ArticleJournal of surgical oncology2026

Insulin-Dependence and Survival in Pancreatic Neuroendocrine Tumors: Results From the US-NTSG Group.

Muhammad Bilal Mirza, Jordan J Baechle, Paula Marincola Smith, Danish Ali, Mary Dillhoff, George Poultsides, Flavio G Rocha, Clifford S Cho, Emily R Winslow, Ryan C Fields and 2 more

Abstract read
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In one paragraph

Article in Journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Muhammad Bilal MirzaDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Jordan J BaechleDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Paula Marincola SmithDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Danish AliDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Mary DillhoffThe Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
George PoultsidesStanford University Medical Center, Stanford, CA, USA.
Flavio G RochaVirginia Mason Medical Center, Seattle, WA, USA.ORCID https://orcid.org/0000-0002-1656-5108
Clifford S ChoDivision of Hepatopancreatobiliary and Advanced Gastrointestinal Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Emily R WinslowUniversity of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Ryan C FieldsWashington University School of Medicine, St Louis, MO, USA.
Shishir K MaithelDepartment of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA.ORCID https://orcid.org/0000-0002-3591-8925
Kamran IdreesDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPNETs are rare pancreatic malignancies originating from islet cells and exhibit a strong co-occurrence with Diabetes Mellitus (DM), associated with worse survival outcomes. However, studies have yet to delineate the impact of insulin dependent (IDDM) and non-insulin dependent (NIDDM) on poor oncological outcomes.

methodsUtilizing the U.S. Neuroendocrine Tumor Study Group database (1999-2016), we performed a retrospective cohort study of adult patients who underwent primary surgical resection of PNETs. Patients were categorized based on preoperative diagnosis into non-DM, NIDDM, and IDDM cohorts. We used the Kaplan-Meier method and log-rank test to study cancer-specific survival (CSS). Cox proportional Hazards models were used to assess the impact of IDDM on CSS.

resultsOf the 1122 patients included in the analysis, 870 (77%) were non-DM, 168 (15%) were NIDDM, and 84 (8%) were IDDM. The groups were similar in tumor stage and grade. However, they differed in sex, BMI, age, ASA class, tumor location, preoperative HbA1c, and serum glucose (p-value < 0.05). Patients with IDDM had significantly decreased 5-year CSS compared to patients without IDDM (CSS: IDDM 85%, NIDDM 94%, non-DM 93%, NIDDM + non-DM 93%; p < 0.01). On multivariate analysis, IDDM was independently associated with worse CSS (HR 2.27, 95% Confidence Interval 1.15-4.45, p = 0.02).

conclusionInsulin dependence is associated with worse cancer-specific survival in PNET patients following surgical resection compared to PNET patients with NIDDM or without DM.

Indexed as

Diabetes Mellitus, Type 2InsulinNeuroendocrine TumorsPancreatic NeoplasmsAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateUnited StatesInsulincancer‐specific survivaldiabetes mellitusinsulin dependent diabetes mellitusneuroendocrine tumornon‐insulin dependent diabetes mellituspancreatic cancerpancreatic neuroendocrine tumor

Identifiers

PMID41520322
PMCPMC12863235

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.