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Highlights der Pankreaschirurgie: erweiterte Indikationen bei neuroendokrinen Tumoren des Pankreas

Highlights of pancreatic surgery: extended indications in pancreatic neuroendocrine tumors

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Zusammenfassung

Fortgeschrittene neuroendokrine Tumoren des Pankreas (paNET) zeichnen sich zumeist durch eine Infiltration vaskulärer Strukturen und/oder Nachbarorgane aus. Die Indikation zur Resektion sollte sich in diesen Fällen an der Möglichkeit einer R0-Resektion messen. Obwohl die Datenlage für diese seltene Entität begrenzt ist, zeigen kleinere Fallserien signifikante Überlebensvorteile für Patienten, die im Stadium des lokal fortgeschrittenen paNET radikal reseziert wurden. Sowohl Gefäßrekonstruktionen als auch multiviszerale Resektionen sollten, sofern diese an erfahrenen Zentren durchgeführt werden, als kurative Therapieoption verstanden werden. Das sehr besondere biologische Verhalten der paNET und das oftmals junge Patientenalter rechtfertigen ein deutlich aggressiveres Vorgehen im Vergleich zum duktalen Adenokarzinom des Pankreas.

Abstract

Advanced pancreatic neuroendocrine tumors (paNET) are mostly characterized by infiltration of vascular structures and/or neighboring organs. The indications for resection in these cases should be measured based on the possibility of an R0 resection. Although the data situation for this rare entity is limited, small case series have shown a significant survival advantage in patients who underwent a radical resection in locally advanced stages of paNET. Both vascular reconstruction and multivisceral resection, when performed at experienced centers, should be considered as curative treatment options. The very special biological behavior of the paNET and the often young patient age justify a much more aggressive approach compared to the pancreatic ductal adenocarcinoma.

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Authors and Affiliations

  1. Klinik und Poliklinik für Viszeral‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland

    F. Oehme, S. Hempel, M. Distler & J. Weitz

  2. National Center for Tumor Diseases (NCT/UCC), Dresden, Deutschland

    F. Oehme, S. Hempel, M. Distler & J. Weitz

  3. German Cancer Research Center (DKFZ), Heidelberg, Deutschland

    F. Oehme, S. Hempel, M. Distler & J. Weitz

  4. Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland

    F. Oehme, S. Hempel, M. Distler & J. Weitz

  5. Helmholtz-Zentrum Dresden – Rossendorf (HZDR), Dresden, Deutschland

    F. Oehme, S. Hempel, M. Distler & J. Weitz

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  1. F. Oehme
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  2. S. Hempel
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  3. M. Distler
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  4. J. Weitz
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Correspondence to F. Oehme.

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Interessenkonflikt

F. Oehme, S. Hempel, M. Distler und J. Weitz geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Oehme, F., Hempel, S., Distler, M. et al. Highlights der Pankreaschirurgie: erweiterte Indikationen bei neuroendokrinen Tumoren des Pankreas. Chirurgie 93, 751–757 (2022). https://doi.org/10.1007/s00104-022-01646-3

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