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Therapy for Locoregional Disease: Pancreas

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Book cover Neuroendocrine Tumors in Real Life

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Abstract

Surgery is the mainstay for the treatment of localized pancreatic neuroendocrine neoplasm tumors (PanNENs). Either formal or limited pancreatic resections are commonly used for large (> 2 cm), sporadic PanNENs and for functioning neoplasms. However, given the high rate of perioperative morbidity and mortality after pancreatic surgery and the indolent behavior of PanNETs, a conservative approach consisting of active surveillance has been proposed for small, nonfunctioning, low-to-intermediate-grade tumors. Treatment of locally advanced PanNENs appears particularly challenging. Although surgery can be proposed in the presence of tumor invasion of nearby organs, it is currently unclear whether an aggressive surgical approach is associated with improved survival outcomes. On the other hand, it has been suggested that chemotherapy or peptide receptor radionuclide therapy (PRRT) is effective in the neoadjuvant setting and may lead to increased rates of curative resections in patients with locally advanced disease. Studies investigating the molecular underpinnings of PanNENs in relation to their clinical behavior are needed for optimal treatment tailoring.

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Authors and Affiliations

  1. Department of Pancreatic Surgery, San Raffaele Scientific Institute, Milan, Italy

    Francesca Muffatti, Stefano Partelli & Massimo Falconi

  2. Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari «Aldo Moro», Bari, Italy

    Mauro Cives & Franco Silvestris

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  1. Francesca Muffatti
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  2. Mauro Cives
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  3. Stefano Partelli
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  4. Franco Silvestris
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  5. Massimo Falconi
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Correspondence to Massimo Falconi .

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Editors and Affiliations

  1. ENETs Center of Excellence for Neuroendocrine Tumours, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy

    Annamaria Colao

  2. ENETs Center of Excellence for Neuroendocrine Tumours, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy

    Antongiulio Faggiano

  3. Endocrine Oncology, Internal Medicine Department, Erasmus University, Rotterdam, Zuid-Holland, The Netherlands

    Wouter de Herder

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Muffatti, F., Cives, M., Partelli, S., Silvestris, F., Falconi, M. (2018). Therapy for Locoregional Disease: Pancreas. In: Colao, A., Faggiano, A., de Herder, W. (eds) Neuroendocrine Tumors in Real Life. Springer, Cham. https://doi.org/10.1007/978-3-319-59024-0_17

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