| アブストラクト | CONTEXT: Insulinoma is the most common pancreatic functional neuroendocrine neoplasm, yet little information on recent clinical practice in patients with insulinoma, especially malignant insulinoma, is available. OBJECTIVE: This work aims to clarify the characteristics and practice patterns in patients with insulinoma using a national inpatient database. METHODS: Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified patients with insulinoma admitted between 2010 and 2018. We compared background characteristics and therapeutic interventions between patients with benign and malignant insulinoma. We also estimated the incidence of insulinoma using the number of patients with newly diagnosed insulinoma in 2012. RESULTS: We identified 844 patients with benign insulinoma and 102 patients with malignant insulinoma. Patients with malignant insulinoma were younger (median, 55.5 vs 66.0 years, P < .001) and less likely to be female (55.9% vs 65.3%, P = .061) than patients with benign insulinoma. Analysis of therapeutic interventions revealed that patients with malignant insulinoma more frequently received medications (71.6% vs 49.6%, P < .001) but less frequently underwent pancreatic surgery (57.8% vs 72.0%, P = .003). Older patients were a smaller proportion of those undergoing surgery and a larger proportion of those managed with medications without surgery (P < .001). The incidence of insulinoma was estimated to be 3.27 (95% CI, 2.93-3.61) individuals per million Japanese adult population per year. CONCLUSION: The present study using a nationwide database had a larger sample size than previous studies and revealed definitive differences in patient characteristics and therapeutic patterns between benign and malignant insulinoma. |
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| 投稿日 | 2021/8/4 |
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| 投稿者 | Kurakawa, Kayo Ikeda; Okada, Akira; Manaka, Katsunori; Konishi, Takaaki; Jo, Taisuke; Ono, Sachiko; Uda, Kazuaki; Michihata, Nobuaki; Matsui, Hiroki; Fushimi, Kiyohide; Yamaguchi, Satoko; Yamauchi, Toshimasa; Nangaku, Masaomi; Yasunaga, Hideo; Kadowaki, Takashi |
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| ジャーナル名 | The Journal of clinical endocrinology and metabolism |
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| 組織名 | Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate;School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.;Division of Nephrology and Endocrinology, Graduate School of Medicine, The;University of Tokyo, Tokyo 113-8655, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo 113-0033, Japan.;Department of Breast and Endocrine Surgery, Graduate School of Medicine, The;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo 113-0033, Japan.;Department of Eat-loss Medicine, Graduate School of Medicine, The University of;Tokyo, Tokyo 113-8655, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo 113-8510, Japan.;Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The;University of Tokyo, Tokyo, 113-8655, Japan.;Toranomon Hospital, Tokyo 105-8470, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/34343300/ |
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