In various studies a number of features of MEN1 patients have been reported to have prognostic significance, including age at MEN1 onset/diagnosis;46,150,383 disease duration;78,141 presence of a family history;46,150 presence of any PET including gastrinoma, glucagonoma, insulinoma, VIPoma, somatostatinoma, and nonfunctional;71,88,150,217,233,234,389,465 presence of adrenal disease;150,228,388,390,465 presence of lung,368,465 gastric,141,326 or thymic carcinoid tumors;111,131,150,151,413,414,465 and severity and control of HPT.46,88,224,226,328,444,465 We compared each of these features in NIH patients by survival status (Table 5). Deceased patients, compared to alive patients, more frequently had >3 parathyroidectomies (p = 0.008) to control the HPT, suggesting they may have had more severe HPT; more frequently had a gastrinoma with another functional syndrome such as carcinoid syndrome or Cushing syndrome/disease (p = 0.0033); and more frequently had gastrinomas with another functional PET, particularly insulinomas (p = 0.031). Deceased patients tended to have a positive family history of MEN1 more frequently than alive patients (88% vs 67%, p = 0.052) and they were less likely to have had a cutaneous manifestation of MEN1 detected (p = 0.051). There was no significant difference between the 2 patient groups in their age at MEN1 onset or diagnosis or age at onset of HPT or first parathyroidectomy; in the duration of follow-up from time of MEN1 diagnosis, from onset of HPT to last follow-up, or from onset of HPT to first parathyroidectomy; in the number of parathyroid glands removed; presence of renal colic; or any other feature of MEN1 including frequency of pituitary disease, HPT, adrenal disease, any carcinoid tumor, any MEN1-related skin disorders, or the initial MEN1 presenting feature.