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Surgery for primary pancreatic neuroendocrine tumors

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Journal of Gastrointestinal Surgery Aims and scope

Conclusions

Currently, surgery for insulinoma is curative in nearly every patient, even those with MEN1, and fu-ture direction seems to be to make it more cosmeti-cally acceptable and less morbid by trying to accomplish the same procedure laparoscopically. Surgery for gastrinoma and nonfunctional NE tu-mors is curative in approximately 50% of patients. Duodenotomy is indicated during surgery for gastri-noma, because it increases tumor detection and cure rate. Patients with MEN1 with gastrinoma remain a challenge. With our current approach in these pa-tients, the cure rate is low, but the long-term survival remains excellent. The role of routine pancreaticoduodenectomy for sporadic and MEN1 NE tumors is currently unclear. It may increase cure rate, but it may also increase morbidity in pa-tients with a low, long-term tumor death rate.

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References

  1. Cadiot G, Vuagnat A, Doukhan I, et al. Prognostic factors in patients with Zollinger-Ellison syndrome and multiple endo-crine neoplasia type 1. Gastroenterology 1999;116:286–293.

    Article  PubMed  CAS  Google Scholar 

  2. Weber HC, Venzon DJ, Lin JT, et al. Determinants of met-astatic rate and survival in patients with Zollinger-Ellison syndrome: a prospective long-term study. Gastroenterology 1995;108:1637–1649.

    Article  PubMed  CAS  Google Scholar 

  3. Norton JA, Alexander HR, Fraker DL, et al. Possible pri-mary lymph node gastrinoma: occurrence, natural history and predictive factors. A prospective study. Ann Surg 2003; 237:650–659.

    Article  PubMed  Google Scholar 

  4. Thompson NW, Bondeson AG, Bondeson L, et al. The sur-gical treatment of gastrinoma in MENI syndrome patients. Surgery 1989;106:1081–1085.

    PubMed  CAS  Google Scholar 

  5. Thompson NW. Current concepts in the surgical manage-ment of multiple endocrine neoplasia type 1 pancreatic-duo-denal disease. Results in the treatment of 40 patients with Zollinger-Ellison syndrome, hypoglycaemia or both. J Intern Med 1998;243:495–500.

    Article  PubMed  CAS  Google Scholar 

  6. Pipeleers-Marichal M, Somers G, Willems G, et al. Gastri-nomas in the duodenums of patients with multiple endocrine neoplasia type 1 and the Zollinger-Ellison syndrome. N Engl J Med 1990;322:723–727.

    Article  PubMed  CAS  Google Scholar 

  7. Norton JA, Fraker DL, Alexander HR, et al. Surgery to cure the Zollinger-Ellison syndrome. N Engl J Med 1999;341:635–644.

    Article  PubMed  CAS  Google Scholar 

  8. Hiramoto JS, Feldstein VA, Laberge JM, Norton JA. Intra-operative ultrasound and preoperative localization detects all occult insulinomas. Arch Surg 2001;136:1020–1025.

    Article  PubMed  CAS  Google Scholar 

  9. Orbuch M, Doppman JL, Strader DB, et al. Imaging for pan-creatic endocrine tumor localization: recent advances. In: Mignon M, Jensen RT, eds. Endocrine Tumors of the Pan-creas: Recent Advances in Research and Management. Fron-tiers of Gastrointestinal Research. Basel, Switzerland: S. Karger, 1995, pp 268–281.

    Google Scholar 

  10. Gibril F, Reynolds JC, Doppman JL, et al. Somatostatin re-ceptor scintigraphy: its sensitivity compared with that of other imaging methods in detecting primary and metastatic gastrinomas: a prospective study. Ann Intern Med 1996; 125:26–34.

    PubMed  CAS  Google Scholar 

  11. Anderson MA, Carpenter S, Thompson NW, et al. Endo-scopic ultrasound is highly accurate and directs management in patients with neuroendocrine tumors of the pancreas. Am J Gastroenterol 2000;95:2271–2277.

    Article  PubMed  CAS  Google Scholar 

  12. Ruszniewski P, Rougier P, Roche A, et al. Hepatic arterial chemoembolization in patients with liver metastases of endo-crine tumors. A prospective phase II study in 24 patients. Cancer 1993;71:2624–2630.

    Article  PubMed  CAS  Google Scholar 

  13. Norton JA, Alexander HR, Fraker D, Venzon D, Gibril F, Jensen RT. Does the use of routine duodenotomy (DU-ODX) affect rate of cure, development of liver metastases or survival in patients with Zollinger-Ellison Syndrome (ZES)? Ann Surg 2004;239:617–625; discussion 626.

    Article  PubMed  Google Scholar 

  14. Gumbs AA, Moore PS, Falconi M, et al. Review of the clin-ical, histological, and molecular aspects of pancreatic endo-crine neoplasms. J Surg Oncol 2002;81:45–53.

    Article  PubMed  CAS  Google Scholar 

  15. Thompson NW. Management of pancreatic endocrine tu-mors in patients with multiple endocrine neoplasia type 1. Surg Oncol Clin North Am 1998;7:881–891.

    CAS  Google Scholar 

  16. Sheppard BC, Norton JA, Doppman JL, Maton PN, Gardner JD, Jensen RT. Management of islet cell tumors in patients with multiple endocrine neoplasia; a prospective study. Surgery 1989;106:1108–1118.

    PubMed  CAS  Google Scholar 

  17. Chanson P, Cadiot G, Murat A. Management of patients and subjects at risk for multiple endocrine neoplasia type 1: MEN1. Horm Res 1997;47:211–220.

    Article  PubMed  CAS  Google Scholar 

  18. Norton JA. Surgical treatment of islet cell tumors with spe-cial emphasis on operative ultrasound. In: Mignon M, Jensen RT, eds. Endocrine Tumors of the Pancreas: Recent Advances in Research and Management. Frontiers in Gastrointestinal Research. Basel, Switzerland: S. Karger, 1995, 309–332.

    Google Scholar 

  19. Stadil F. Treatment of gastrinomas with pancreaticoduode-nectomy. In: Mignon M, Jensen RT, eds. Endocrine Tumors of the Pancreas: Recent Advances in Research and Manage-ment. Series: Frontiers in Gastrointestinal Research. Basel, Switzerland: S. Karger, 1995, pp 333–341.

    Google Scholar 

  20. Declore R, Friesen SR. Role of pancreaticoduodenectomy in the management of primary duodenal wall gastrinomas in patients with Zollinger-Ellison syndrome. Surgery 1992; 112:1016–1022.

    Google Scholar 

  21. Imamura M, Kanda M, Takahashi K, et al. Clinicopatholog-ical characteristics of duodenal microgastrinomas. World J Surg 1992;16:703–709.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Stanford University School of Medicine, Stanford, California

    Jeffrey A. Norton M.D.

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  1. Jeffrey A. Norton M.D.
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Correspondence to Jeffrey A. Norton M.D..

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Norton, J.A. Surgery for primary pancreatic neuroendocrine tumors. J Gastrointest Surg 10, 327–331 (2006). https://doi.org/10.1016/j.gassur.2005.08.023

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