Abstract
Complete resection is the only curative therapy for pancreatic neuroendocrine tumors (PNETs). Due to the slow rate of growth of PNETs and relatively high long-term survival rate, many patients with systemic disease still benefit from surgical resection. Cytoreductive surgery and/or interventional ablative techniques for metastatic disease can significantly palliate symptoms and improve overall survival in certain subtypes. The optimal surgical approach for PNETs is dictated by tumor subtype, disease stage, and whether the patient possesses multiple endocrine neoplasia type 1 or von Hippel-Lindau gene mutations.
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References
Ramage JK, Ahmed A, Ardill J, et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut. 2012;61:6–32.
Sundin A, Garske U, Orlefors H. Nuclear imaging of neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab. 2007;21:69–85.
Atiq M, Bhutani MS, Bektas M, et al. EUS-FNA for pancreatic neuroendocrine tumors: a tertiary cancer center experience. Dig Dis Sci. 2012;57:791–800.
Burns WR, Edil BH. Neuroendocrine pancreatic tumors: guidelines for management and update. Curr Treat Options Oncol. 2012;13:24–34.
Goudard Y, Gaujoux S, Dokmak S, et al. Reappraisal of central pancreatectomy a 12-year single-center experience. JAMA. 2014;149:357.
Cusati D, Zhang L, Harmsen WS, et al. Metastatic nonfunctioning pancreatic neuroendocrine carcinoma to liver: surgical treatment and outcomes. J Am Coll Surg. 2012;215:117–24. discussion 124-115.
Solorzano CC, Lee JE, Pisters PWT, et al. Nonfunctioning islet cell carcinoma of the pancreas: survival results in a contemporary series of 163 patients. Surgery. 2001;130:1078–85.
Libutti SK, Choyke PL, Bartlett DL, et al. Pancreatic neuroendocrine tumors associated with von Hippel Lindau disease: diagnostic and management recommendations. Surgery. 1998;124:1153–9.
Guglielmi A, Ruzzenente A, Conci S, et al. How much remnant is enough in liver resection? Dig Surg. 2012;29:6–17.
Kleine M, Schrem H, Vondran FWR, et al. Extended surgery for advanced pancreatic endocrine tumours. Br J Surg. 2012;99:88–94.
Dousset B, Saint-Marc O, Pitre J, et al. Metastatic endocrine tumors: medical treatment, surgical resection, or liver transplantation. World J Surg. 1996;20:908–15.
Chen H, Hardacre JM, Uzar A, et al. Isolated liver metastases from neuroendocrine tumors: does resection prolong survival? J Am Coll Surg. 1998;187:88–92.
Ellison TA, Wolfgang CL, Shi C, et al. A single institution’s 26-year experience with nonfunctional pancreatic neuroendocrine tumors: a validation of current staging systems and a new prognostic nomogram. Ann Surg. 2014;259:204–12.
Fischer L, Kleeff J, Esposito I, et al. Clinical outcome and long‐term survival in 118 consecutive patients with neuroendocrine tumours of the pancreas. Br J Surg. 2008;95:627–35.
De Jong MC, Farnell MB, Sclabas G, et al. Liver-directed therapy for hepatic metastases in patients undergoing pancreaticoduodenectomy: a dual-center analysis. Ann Surg. 2010;252:142–8.
Berber E, Flesher N, Siperstein AE. Laparoscopic radiofrequency ablation of neuroendocrine liver metastases. World J Surg. 2002;26:985–90.
Gupta S, Johnson MM, Murthy R, et al. Hepatic arterial embolization and chemoembolization for the treatment of patients with metastatic neuroendocrine tumors. Cancer. 2005;104:1590–602.
Mazzaferro V, Pulvirenti A, Coppa J. Neuroendocrine tumors metastatic to the liver: how to select patients for liver transplantation? J Hepatol. 2007;47:460–6.
Nikfarjam M, Warshaw AL, Axelrod L, et al. Improved contemporary surgical management of insulinomas: a 25-year experience at the Massachusetts General Hospital. Ann Surg. 2008;247:165–72.
Proye C, Malvaux P, Pattou F, et al. Noninvasive imaging of insulinomas and gastrinomas with endoscopic ultrasonography and somatostatin receptor scintigraphy. Surgery. 1998;124:1134–43. discussion 1143-1134.
Atema JJ, Amri R, Busch OR, et al. Surgical treatment of gastrinomas: a single-centre experience. HPB (Oxford). 2012;14:833–8.
Tonelli F, Fratini G, Nesi G, et al. Pancreatectomy in multiple endocrine neoplasia type 1-related gastrinomas and pancreatic endocrine neoplasias. Ann Surg. 2006;244:61.
Thakker RV, Newey PJ, Walls GV, et al. Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1). J Clin Endocrinol Metab. 2012;97:2990–3011.
Hyder O, Dodson RM, Nathan H, et al. Influence of patient, physician, and hospital factors on 30-day readmission following pancreatoduodenectomy in the United States. JAMA Surg. 2013;148:1095–102.
Kazanjian KK, Reber HA, Hines OJ. Resection of pancreatic neuroendocrine tumors: results of 70 cases. Arch Surg. 2006;141:765–9. discussion 769-770.
Gans SL, van Westreenen HL, Kiewiet JJ, et al. Systematic review and meta-analysis of somatostatin analogues for the treatment of pancreatic fistula. Br J Surg. 2012;99:754–60.
Yang C, Wu HS, Chen XL, et al. Pylorus-preserving versus pylorus-resecting pancreaticoduodenectomy for periampullary and pancreatic carcinoma: a meta-analysis. PLoS One. 2014;9:e90316.
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Wu, J.X., Brunicardi, F.C. (2015). Surgical Approaches to Pancreatic Neuroendocrine Tumors. In: Pisegna, J. (eds) Management of Pancreatic Neuroendocrine Tumors. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1798-3_9
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DOI: https://doi.org/10.1007/978-1-4939-1798-3_9
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