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Guideline for the Management of Pancreatic Neuroendocrine Tumor

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Pancreatic Cancer

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Abstract

Pancreatic neuroendocrine neoplasms (PNENs) have been steadily increasing in terms of incidence and prevalence over the last two decades. As a broad variety of tumors in regard to presentation, histology, and prognosis, they represent a growing challenge for the clinicians of many specialties. Lately, surgeons are called to decide whether to offer surgery for neoplasms that may be indolent and very limited and have potentially small benefit from major operations, while in others cases can manifest at advanced stages when symptom control is the only rationale for surgical treatment.

Functioning P-NENs (F-PNENs) are encountered less often than the past more but might be easily recognizable since they cause syndromes from unregulated hormone secretion. They are treated according to the different subtype as they carry different characteristics and prognosis.

No functioning PNENs (NF-PNENS) have been detected more frequently with the refinement in imaging techniques overtime. When of small size, they carry little potential for malignant behavior; instead, the risk increases proportionally with size. According to size and grading, management options may vary from observation only to extensive resections of primary and metastatic deposits up to liver transplantation.

This chapter offers a perspective on the surgical management of the various types of PNENs.

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References

  1. Zollinger RM, Ellison EH. Primary peptic ulcerations of the jeju`num associated with islet cell tumors of the pancreas. Ann Surg. 1955;142(4):709–23.

    Google Scholar 

  2. Metz DC, Jensen RT. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology. 2008;135(5):1469–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Jensen RT, Niederle B, Mitry E, Ramage JK, Steinmuller T, Lewington V, Scarpa A, Sundin A, Perren A, Gross D, O’Connor JM, Pauwels S, Kloppel G, Frascati Consensus Conference, and European Neuroendocrine Tumor Society. Gastrinoma (duodenal and pancreatic). Neuroendocrinology. 2006;84(3):173–82.

    Article  CAS  PubMed  Google Scholar 

  4. Jensen RT, Cadiot G, Brandi ML, de Herder WW, Kaltsas G, Komminoth P, Scoazec J-Y, Salazar R, Sauvanet A, Kianmanesh R, Barcelona Consensus Conference participants. ENETS Consensus Guidelines for the management of patients with digestive neuroendocrine neoplasms: functional pancreatic endocrine tumor syndromes. Neuroendocrinology. 2012;95(2):98–119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Norton JA, Fraker DL, Alexander HR, Gibril F, Liewehr DJ, Venzon DJ, Jensen RT. Surgery increases survival in patients with gastrinoma. Ann Surg. 2006;244(3):410–9.

    PubMed  PubMed Central  Google Scholar 

  6. Morrow EH, Norton JA. Surgical management of Zollinger-Ellison syndrome; state of the art. Surg Clin North Am. 2009;89(5):1091–103.

    Article  PubMed  Google Scholar 

  7. Norton JA. Surgical treatment and prognosis of gastrinoma. Best Pract Res Clin Gastroenterol. 2005;19(5):799–805.

    Article  PubMed  Google Scholar 

  8. Fendrich V, Waldmann J, Bartsch DK, Langer P. Surgical management of pancreatic endocrine tumors. Nat Rev Clin Oncol. 2009;6(7):419–28.

    Article  PubMed  Google Scholar 

  9. Thompson NW. Current concepts in the surgical management of multiple endocrine neoplasia type 1 pancreatic-duodenal disease. Results in the treatment of 40 patients with Zollinger-Ellison syndrome, hypoglycaemia or both. J Intern Med. 1998;243(6):495–500.

    Article  CAS  PubMed  Google Scholar 

  10. Lopez CL, Falconi M, Waldmann J, Boninsegna L, Fendrich V, Goretzki PK, Langer P, Kann PH, Partelli S, Bartsch DK. Partial pancreaticoduodenectomy can provide cure for duodenal gastrinoma associated with multiple endocrine neoplasia type 1. Ann Surg. 2013;257(2):308–14.

    Article  PubMed  Google Scholar 

  11. Bartsch DK, Waldmann J, Fendrich V, Boninsegna L, Lopez CL, Partelli S, Falconi M. Impact of lymphadenectomy on survival after surgery for sporadic gastrinoma. Br J Surg. 2012;99(9):1234–40.

    Article  CAS  PubMed  Google Scholar 

  12. Norton JA, Fraker DL, Alexander HR, Jensen RT. Value of surgery in patients with negative imaging and sporadic Zollinger-Ellison syndrome. Ann Surg. 2012;256(3):509–17.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Fraker DL, Norton JA, Alexander HR, Venzon DJ, Jensen RT. Surgery in Zollinger-Ellison syndrome alters the natural history of gastrinoma. Ann Surg. 1994;220(3):320–8; discussion 328–330.

    Google Scholar 

  14. Cadiot G, Vuagnat A, Doukhan I, Murat A, Bonnaud G, Delemer B, Thiéfin G, Beckers A, Veyrac M, Proye C, Ruszniewski P, Mignon M. Prognostic factors in patients with Zollinger-Ellison syndrome and multiple endocrine neoplasia type 1. Groupe d’Etude des Néoplasies Endocriniennes Multiples (GENEM and groupe de Recherche et d’Etude du Syndrome de Zollinger-Ellison (GRESZE)). Gastroenterology. 1999;116(2):286–93.

    Article  CAS  PubMed  Google Scholar 

  15. Bartsch DK, Fendrich V, Langer P, Celik I, Kann PH, Rothmund M. Outcome of duodenopancreatic resections in patients with multiple endocrine neoplasia type 1. Ann Surg. 2005;242(6):757–64. discussion 764–766

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kunz PL, Reidy-Lagunes D, Anthony LB, Bertino EM, Brendtro K, Chan JA, Chen H, Jensen RT, Kim MK, Klimstra DS, Kulke MH, Liu EH, Metz DC, Phan AT, Sippel RS, Strosberg JR, Yao JC, North American Neuroendocrine Tumor Society. Consensus guidelines for the management and treatment of neuroendocrine tumors. Pancreas. 2013;42(4):557–77.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Tonelli F, Fratini G, Nesi G, Tommasi MS, Batignani G, Falchetti A, Brandi ML. Pancreatectomy in multiple endocrine neoplasia type 1-related gastrinomas and pancreatic endocrine neoplasias. Ann Surg. 2006;244(1):61–70.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Mehrabi A, Fischer L, Hafezi M, Dirlewanger A, Grenacher L, Diener MK, Fonouni H, Golriz M, Garoussi C, Fard N, Rahbari NN, Werner J, Büchler MW. A systematic review of localization, surgical treatment options, and outcome of insulinoma. Pancreas. 2014;43(5):675–86.

    Article  PubMed  Google Scholar 

  19. Su A-P, Ke N-W, Zhang Y, Liu X-B, Hu W-M, Tian B-L, Zhang Z-D. Is laparoscopic approach for pancreatic insulinomas safe? Results of a systematic review and meta-analysis. J Surg Res. 2014;186(1):126–34.

    Article  PubMed  Google Scholar 

  20. Gimm O, König E, Thanh PN, Brauckhoff M, Karges W, Dralle H. Intra-operative quick insulin assay to confirm complete resection of insulinomas guided by selective arterial calcium injection (SACI). Langenbecks Arch Surg Dtsch Ges Für Chir. 2007;392(6):679–84.

    Article  Google Scholar 

  21. Keutgen XM, Nilubol N, Kebebew E. Malignant-functioning neuroendocrine tumors of the pancreas: A survival analysis. Surgery. 2016;159(5):1382–9.

    Google Scholar 

  22. Crippa S, Zerbi A, Boninsegna L, Capitanio V, Partelli S, Balzano G, Pederzoli P, Di Carlo V, Falconi M. Surgical management of insulinomas: short- and long-term outcomes after enucleations and pancreatic resections. Arch Surg Chic Ill 1960. 2012;147(3):261–6.

    Google Scholar 

  23. Jensen RT, Berna MJ, Bingham DB, Norton JA. Inherited pancreatic endocrine tumor syndromes: advances in molecular pathogenesis, diagnosis, management, and controversies. Cancer. 2008;113(7 Suppl):1807–43.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Oberg K. Pancreatic endocrine tumors. Semin Oncol. 2010;37(6):594–618.

    Article  PubMed  Google Scholar 

  25. O’Toole D, Salazar R, Falconi M, Kaltsas G, Couvelard A, de Herder WW, Hyrdel R, Nikou G, Krenning E, Vullierme M-P, Caplin M, Jensen R, Eriksson B, Frascati Consensus Conference, and European Neuroendocrine Tumor Society. Rare functioning pancreatic endocrine tumors. Neuroendocrinology. 2006;84(3):189–95.

    Article  PubMed  Google Scholar 

  26. Elias D, Goéré D, Leroux G, Dromain C, Leboulleux S, de Baere T, Ducreux M, Baudin E. Combined liver surgery and RFA for patients with gastroenteropancreatic endocrine tumors presenting with more than 15 metastases to the liver. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 2009;35(10):1092–7.

    CAS  Google Scholar 

  27. Crippa S, Partelli S, Zamboni G, Scarpa A, Tamburrino D, Bassi C, Pederzoli P, Falconi M. Incidental diagnosis as prognostic factor in different tumor stages of nonfunctioning pancreatic endocrine tumors. Surgery. 2014;155(1):145–53.

    Article  PubMed  Google Scholar 

  28. Kuo EJ, Salem RR. Population-level analysis of pancreatic neuroendocrine tumors 2 cm or less in size. Ann Surg Oncol. 2013;20(9):2815–21.

    Article  PubMed  Google Scholar 

  29. Cheema A, Weber J, Strosberg JR. Incidental detection of pancreatic neuroendocrine tumors: an analysis of incidence and outcomes. Ann Surg Oncol. 2012;19(9):2932–6.

    Article  PubMed  Google Scholar 

  30. Hill JS, McPhee JT, McDade TP, Zhou Z, Sullivan ME, Whalen GF, Tseng JF. Pancreatic neuroendocrine tumors: the impact of surgical resection on survival. Cancer. 2009;115(4):741–51.

    Article  PubMed  Google Scholar 

  31. Scarpa A, Mantovani W, Capelli P, Beghelli S, Boninsegna L, Bettini R, Panzuto F, Pederzoli P, delle Fave G, Falconi M. Pancreatic endocrine tumors: improved TNM staging and histopathological grading permit a clinically efficient prognostic stratification of patients. Mod Pathol Off J U S Can Acad Pathol Inc. 2010;23(6):824–33.

    CAS  Google Scholar 

  32. Bettini R, Partelli S, Boninsegna L, Capelli P, Crippa S, Pederzoli P, Scarpa A, Falconi M. Tumor size correlates with malignancy in nonfunctioning pancreatic endocrine tumor. Surgery. 2011;150(1):75–82.

    Article  PubMed  Google Scholar 

  33. Lee LC, Grant CS, Salomao DR, Fletcher JG, Takahashi N, Fidler JL, Levy MJ, Huebner M. Small, nonfunctioning, asymptomatic pancreatic neuroendocrine tumors (PNETs): role for nonoperative management. Surgery. 2012;152(6):965–74.

    Article  PubMed  Google Scholar 

  34. Fong Y, Gonen M, Rubin D, Radzyner M, Brennan MF. Long-term survival is superior after resection for cancer in high-volume centers. Ann Surg. 2005;242(4):540–4. discussion 544–547

    PubMed  PubMed Central  Google Scholar 

  35. Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M, International Study Group on Pancreatic Fistula Definition. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138(1):8–13.

    Article  PubMed  Google Scholar 

  36. Atema JJ, Jilesen APJ, Busch ORC, van Gulik TM, Gouma DJ, Nieveen van Dijkum EJM. Pancreatic fistulae after pancreatic resections for neuroendocrine tumours compared with resections for other lesions. HPB. 2015;17(1):38–45.

    Article  PubMed  Google Scholar 

  37. Gaujoux S, Partelli S, Maire F, D’Onofrio M, Larroque B, Tamburrino D, Sauvanet A, Falconi M, Ruszniewski P. Observational study of natural history of small sporadic nonfunctioning pancreatic neuroendocrine tumors. J Clin Endocrinol Metab. 2013;98(12):4784–9.

    Article  CAS  PubMed  Google Scholar 

  38. Sadot E, Reidy-Lagunes DL, Tang LH, Do RKG, Gonen M, D’Angelica MI, DeMatteo RP, Kingham TP, Groot Koerkamp B, Untch BR, Brennan MF, Jarnagin WR, Allen PJ. Observation versus resection for small asymptomatic pancreatic neuroendocrine tumors: a matched case-control study. Ann Surg Oncol. 2016;23(4):1361–70.

    Article  PubMed  Google Scholar 

  39. Falconi M, Mantovani W, Crippa S, Mascetta G, Salvia R, Pederzoli P. Pancreatic insufficiency after different resections for benign tumours. Br J Surg. 2008;95(1):85–91.

    Article  CAS  PubMed  Google Scholar 

  40. Aranha GV, Shoup M. Nonstandard pancreatic resections for unusual lesions. Am J Surg. 2005;189(2):223–8.

    Article  PubMed  Google Scholar 

  41. Fernández-Cruz L, Blanco L, Cosa R, Rendón H. Is laparoscopic resection adequate in patients with neuroendocrine pancreatic tumors? World J Surg. 2008;32(5):904–17.

    Article  PubMed  Google Scholar 

  42. Plöckinger U, Wiedenmann B. Diagnosis of non-functioning neuro-endocrine gastro-enteropancreatic tumours. Neuroendocrinology. 2004;80(Suppl 1):35–8.

    Google Scholar 

  43. Falconi M, Plockinger U, Kwekkeboom DJ, Manfredi R, Korner M, Kvols L, Pape UF, Ricke J, Goretzki PE, Wildi S, Steinmuller T, Oberg K, Scoazec J-Y, Frascati Consensus Conference, and European Neuroendocrine Tumor Society. Well-differentiated pancreatic nonfunctioning tumors/carcinoma. Neuroendocrinology. 2006;84(3):196–211.

    Article  CAS  PubMed  Google Scholar 

  44. Rindi G, Arnold R, Bosman FT, et al. Nomenclature and classification of neuroendocrine neoplasms of the digestive system, in WHO Classification of Tumours of the Digestive System. 4th ed. Lyon: International Agency for Research on cancer (IARC); 2010. p. 13.

    Google Scholar 

  45. Basturk O, Tang L, Hruban RH, Adsay V, Yang Z, Krasinskas AM, Vakiani E, La Rosa S, Jang K-T, Frankel WL, Liu X, Zhang L, Giordano TJ, Bellizzi AM, Chen J-H, Shi C, Allen P, Reidy DL, Wolfgang CL, Saka B, Rezaee N, Deshpande V, Klimstra DS. Poorly differentiated neuroendocrine carcinomas of the pancreas: a clinicopathologic analysis of 44 cases. Am J Surg Pathol. 2014;38(4):437–47.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Crippa S, Partelli S, Bassi C, Berardi R, Capelli P, Scarpa A, Zamboni G, Falconi M. Long-term outcomes and prognostic factors in neuroendocrine carcinomas of the pancreas: morphology matters. Surgery. 2016;159(3):862–71.

    Article  PubMed  Google Scholar 

  47. Strosberg JR, Cheema A, Weber J, Han G, Coppola D, Kvols LK. Prognostic validity of a novel American Joint Committee on Cancer Staging Classification for pancreatic neuroendocrine tumors. J Clin Oncol Off J Am Soc Clin Oncol. 2011;29(22):3044–9.

    Article  Google Scholar 

  48. Frilling A, Modlin IM, Kidd M, Russell C, Breitenstein S, Salem R, Kwekkeboom D, Lau W, Klersy C, Vilgrain V, Davidson B, Siegler M, Caplin M, Solcia E, Schilsky R, Working Group on Neuroendocrine Liver Metastases. Recommendations for management of patients with neuroendocrine liver metastases. Lancet Oncol. 2014;15(1):e8–21.

    Article  PubMed  Google Scholar 

  49. Capurso G, Bettini R, Rinzivillo M, Boninsegna L, Delle Fave G, Falconi M. Role of resection of the primary pancreatic neuroendocrine tumour only in patients with unresectable metastatic liver disease: a systematic review. Neuroendocrinology. 2011;93(4):223–9.

    Article  CAS  PubMed  Google Scholar 

  50. Goudet P, Murat A, Binquet C, Cardot-Bauters C, Costa A, Ruszniewski P, Niccoli P, Ménégaux F, Chabrier G, Borson-Chazot F, Tabarin A, Bouchard P, Delemer B, Beckers A, Bonithon-Kopp C. Risk factors and causes of death in MEN1 disease. A GTE (Groupe d’Etude des Tumeurs Endocrines) cohort study among 758 patients. World J Surg. 2010;34(2):249–55.

    Article  PubMed  Google Scholar 

  51. Lowney JK, Frisella MM, Lairmore TC, Doherty GM. Pancreatic islet cell tumor metastasis in multiple endocrine neoplasia type 1: correlation with primary tumor size. Surgery. 1998;124(6):1043–8. discussion 1048–1049

    Article  CAS  PubMed  Google Scholar 

  52. Falconi M, Bartsch DK, Eriksson B, Klöppel G, Lopes JM, O’Connor JM, Salazar R, Taal BG, Vullierme MP, O’Toole D, Barcelona Consensus Conference participants. ENETS Consensus Guidelines for the management of patients with digestive neuroendocrine neoplasms of the digestive system: well-differentiated pancreatic non-functioning tumors. Neuroendocrinology. 2012;95(2):120–34.

    Google Scholar 

  53. Triponez F, Dosseh D, Goudet P, Cougard P, Bauters C, Murat A, Cadiot G, Niccoli-Sire P, Chayvialle J-A, Calender A, Proye CAG. Epidemiology data on 108 MEN 1 patients from the GTE with isolated nonfunctioning tumors of the pancreas. Ann Surg. 2006;243(2):265–72.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Partelli S, Tamburrino D, Lopez C, Albers M, Milanetto AC, Pasquali C, Manzoni M, Toumpanakis C, Fusai G, Bartsch D, Falconi M. Active surveillance versus surgery of nonfunctioning pancreatic neuroendocrine neoplasms ≤2 cm in MEN1 patients. Neuroendocrinology. 2016;103(6):779–86.

    Google Scholar 

  55. Kouvaraki MA, Shapiro SE, Cote GJ, Lee JE, Yao JC, Waguespack SG, Gagel RF, Evans DB, Perrier ND. Management of pancreatic endocrine tumors in multiple endocrine neoplasia type 1. World J Surg. 2006;30(5):643–53.

    Article  PubMed  Google Scholar 

  56. Triponez F, Goudet P, Dosseh D, Cougard P, Bauters C, Murat A, Cadiot G, Niccoli-Sire P, Calender A, Proye CAG, French Endocrine Tumor Study Group. Is surgery beneficial for MEN1 patients with small (< or = 2 cm), nonfunctioning pancreaticoduodenal endocrine tumor? An analysis of 65 patients from the GTE. World J Surg. 2006;30(5):654–62. discussion 663–664

    Article  PubMed  Google Scholar 

  57. Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, Abdalla EK, Fleming JB, Vauthey J-N, Rashid A, Evans DB. One hundred years after ‘carcinoid’: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol Off J Am Soc Clin Oncol. 2008;26(18):3063–72.

    Article  Google Scholar 

  58. Pavel M, Baudin E, Couvelard A, Krenning E, Öberg K, Steinmüller T, Anlauf M, Wiedenmann B, Salazar R, Barcelona Consensus Conference participants. ENETS Consensus Guidelines for the management of patients with liver and other distant metastases from neuroendocrine neoplasms of foregut, midgut, hindgut, and unknown primary. Neuroendocrinology. 2012;95(2):157–76.

    Article  CAS  PubMed  Google Scholar 

  59. Bettini R, Boninsegna L, Mantovani W, Capelli P, Bassi C, Pederzoli P, Delle Fave GF, Panzuto F, Scarpa A, Falconi M. Prognostic factors at diagnosis and value of WHO classification in a mono-institutional series of 180 non-functioning pancreatic endocrine tumours. Ann Oncol Off J Eur Soc Med Oncol ESMO. 2008;19(5):903–8.

    Article  CAS  Google Scholar 

  60. Frilling A, Sotiropoulos GC, Li J, Kornasiewicz O, Plöckinger U. Multimodal management of neuroendocrine liver metastases. HPB. 2010;12(6):361–79.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Partelli S, Inama M, Rinke A, Begum N, Valente R, Fendrich V, Tamburrino D, Keck T, Caplin ME, Bartsch D, Thirlwell C, Fusai G, Falconi M. Long-term outcomes of surgical management of pancreatic neuroendocrine tumors with synchronous liver metastases. Neuroendocrinology. 2015;102(1–2):68–76.

    Article  CAS  PubMed  Google Scholar 

  62. Frilling A, Clift AK. Therapeutic strategies for neuroendocrine liver metastases. Cancer. 2015;121(8):1172–86.

    Article  CAS  PubMed  Google Scholar 

  63. Jaeck D, Oussoultzoglou E, Bachellier P, Lemarque P, Weber JC, Nakano H, Wolf P. Hepatic metastases of gastroenteropancreatic neuroendocrine tumors: safe hepatic surgery. World J Surg. 2001;25(6):689–92.

    Article  CAS  PubMed  Google Scholar 

  64. Frilling A, Li J, Malamutmann E, Schmid K-W, Bockisch A, Broelsch CE. Treatment of liver metastases from neuroendocrine tumours in relation to the extent of hepatic disease. Br J Surg. 2009;96(2):175–84.

    Article  CAS  PubMed  Google Scholar 

  65. Kianmanesh R, Sauvanet A, Hentic O, Couvelard A, Lévy P, Vilgrain V, Ruszniewski P, Belghiti J. Two-step surgery for synchronous bilobar liver metastases from digestive endocrine tumors: a safe approach for radical resection. Ann Surg. 2008;247(4):659–65.

    Article  PubMed  Google Scholar 

  66. Schnitzbauer AA, Lang SA, Goessmann H, Nadalin S, Baumgart J, Farkas SA, Fichtner-Feigl S, Lorf T, Goralcyk A, Hörbelt R, Kroemer A, Loss M, Rümmele P, Scherer MN, Padberg W, Königsrainer A, Lang H, Obed A, Schlitt HJ. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann Surg. 2012;255(3):405–14.

    Article  PubMed  Google Scholar 

  67. Touzios JG, Kiely JM, Pitt SC, Rilling WS, Quebbeman EJ, Wilson SD, Pitt HA. Neuroendocrine hepatic metastases: does aggressive management improve survival. Ann Surg. 2005;241(5):776–83. discussion 783–785

    Article  PubMed  PubMed Central  Google Scholar 

  68. Glazer ES, Tseng JF, Al-Refaie W, Solorzano CC, Liu P, Willborn KA, Abdalla EK, Vauthey J-N, Curley SA. Long-term survival after surgical management of neuroendocrine hepatic metastases. HPB. 2010;12(6):427–33.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Elias D, Lefevre JH, Duvillard P, Goéré D, Dromain C, Dumont F, Baudin E. Hepatic metastases from neuroendocrine tumors with a ‘thin slice’ pathological examination: they are many more than you think. Ann Surg. 2010;251(2):307–10.

    Article  PubMed  Google Scholar 

  70. Gurusamy KS, Ramamoorthy R, Sharma D, Davidson BR. Liver resection versus other treatments for neuroendocrine tumours in patients with resectable liver metastases. Cochrane Database Syst Rev. 2009;2:CD007060.

    Google Scholar 

  71. Birnbaum DJ, Turrini O, Vigano L, Russolillo N, Autret A, Moutardier V, Capussotti L, Le Treut Y-P, Delpero J-R, Hardwigsen J. Surgical management of advanced pancreatic neuroendocrine tumors: short-term and long-term results from an international multi-institutional study. Ann Surg Oncol. 2015;22(3):1000–7.

    Article  PubMed  Google Scholar 

  72. Fischer L, Kleeff J, Esposito I, Hinz U, Zimmermann A, Friess H, Büchler MW. Clinical outcome and long-term survival in 118 consecutive patients with neuroendocrine tumours of the pancreas. Br J Surg. 2008;95(5):627–35.

    Article  CAS  PubMed  Google Scholar 

  73. Gaujoux S, Gonen M, Tang L, Klimstra D, Brennan MF, D’Angelica M, Dematteo R, Allen PJ, Jarnagin W, Fong Y. Synchronous resection of primary and liver metastases for neuroendocrine tumors. Ann Surg Oncol. 2012;19(13):4270–7.

    Article  PubMed  Google Scholar 

  74. Le Treut YP, Grégoire E, Klempnauer J, Belghiti J, Jouve E, Lerut J, Castaing D, Soubrane O, Boillot O, Mantion G, Homayounfar K, Bustamante M, Azoulay D, Wolf P, Krawczyk M, Pascher A, Suc B, Chiche L, de Urbina JO, Mejzlik V, Pascual M, Lodge JPA, Gruttadauria S, Paye F, Pruvot F-R, Thorban S, Foss A, Adam R, For ELITA. Liver transplantation for neuroendocrine tumors in Europe-results and trends in patient selection: a 213-case European liver transplant registry study. Ann Surg. 2013;257(5):807–15.

    Article  PubMed  Google Scholar 

  75. Sher LS, Levi DM, Wecsler JS, Lo M, Petrovic LM, Groshen S, Ji L, Uso TD, Tector AJ, Hamilton AS, Marsh JW, Schwartz ME. Liver transplantation for metastatic neuroendocrine tumors: outcomes and prognostic variables. J Surg Oncol. 2015;112(2):125–32.

    Article  PubMed  Google Scholar 

  76. Coppa J, Pulvirenti A, Schiavo M, Romito R, Collini P, Di Bartolomeo M, Fabbri A, Regalia E, Mazzaferro V. Resection versus transplantation for liver metastases from neuroendocrine tumors. Transplant Proc. 2001;33(1–2):1537–9.

    Article  CAS  PubMed  Google Scholar 

  77. Gedaly R, Daily MF, Davenport D, McHugh PP, Koch A, Angulo P, Hundley JC. Liver transplantation for the treatment of liver metastases from neuroendocrine tumors: an analysis of the UNOS database. Arch Surg Chic Ill 1960. 2011;146(8):953–8.

    Google Scholar 

  78. Frilling A, Malago M, Weber F, Paul A, Nadalin S, Sotiropoulos GC, Cicinnati V, Beckebaum S, Bockisch A, Mueller-Brand J, Hofmann M, Schmid KW, Gerken G, Broelsch CE. Liver transplantation for patients with metastatic endocrine tumors: single-center experience with 15 patients. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc. 2006;12(7):1089–96.

    Google Scholar 

  79. Bonaccorsi-Riani E, Apestegui C, Jouret-Mourin A, Sempoux C, Goffette P, Ciccarelli O, Borbath I, Hubert C, Gigot JF, Hassoun Z, Lerut J. Liver transplantation and neuroendocrine tumors: lessons from a single centre experience and from the literature review. Transpl Int Off J Eur Soc Organ Transplant. 2010;23(7):668–78.

    Article  Google Scholar 

  80. Eriksson J, Stålberg P, Nilsson A, Krause J, Lundberg C, Skogseid B, Granberg D, Eriksson B, Akerström G, Hellman P. Surgery and radiofrequency ablation for treatment of liver metastases from midgut and foregut carcinoids and endocrine pancreatic tumors. World J Surg. 2008;32(5):930–8.

    Article  PubMed  Google Scholar 

  81. Whitney R, Vàlek V, Fages JF, Garcia A, Narayanan G, Tatum C, Hahl M, Martin RCG. Transarterial chemoembolization and selective internal radiation for the treatment of patients with metastatic neuroendocrine tumors: a comparison of efficacy and cost. Oncologist. 2011;16(5):594–601.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Groeschl RT, Pilgrim CHC, Hanna EM, Simo KA, Swan RZ, Sindram D, Martinie JB, Iannitti DA, Bloomston M, Schmidt C, Khabiri H, Shirley LA, Martin RCG, Tsai S, Turaga KK, Christians KK, Rilling WS, Gamblin TC. Microwave ablation for hepatic malignancies: a multiinstitutional analysis. Ann Surg. 2014;259(6):1195–200.

    Article  PubMed  Google Scholar 

  83. Pawlik TM, Izzo F, Cohen DS, Morris JS, Curley SA. Combined resection and radiofrequency ablation for advanced hepatic malignancies: results in 172 patients. Ann Surg Oncol. 2003;10(9):1059–69.

    Article  PubMed  Google Scholar 

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  1. HPB and Liver Transplant Surgery, Royal Free Hospital, NHS Foundation Trust, London, UK

    Gabriele Spoletini & Domenico Tamburrino

  2. Pancreatic Surgery Unit, Pancreas Center, San Raffaele Hospital, “Vita-Salute” University, Via Olgettina, 60, 20132, Milan, Italy

    Francesca Muffatti, Stefano Crippa, Valentina Andreasi, Stefano Partelli & Massimo Falconi

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  1. Gabriele Spoletini
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  2. Domenico Tamburrino
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  3. Francesca Muffatti
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  4. Stefano Crippa
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  5. Valentina Andreasi
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  6. Stefano Partelli
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  7. Massimo Falconi
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Corresponding author

Correspondence to Massimo Falconi .

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Editors and Affiliations

  1. Department of Surgery, Seoul National University, College of Medicine, Seoul, Korea (Republic of)

    Sun-Whe Kim

  2. Department of Surgery, Wakayama Medical University, Wakayama, Japan

    Hiroki Yamaue

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© 2017 Springer-Verlag Berlin Heidelberg

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Spoletini, G. et al. (2017). Guideline for the Management of Pancreatic Neuroendocrine Tumor. In: Kim, SW., Yamaue, H. (eds) Pancreatic Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47181-4_13

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  • DOI: https://doi.org/10.1007/978-3-662-47181-4_13

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-47180-7

  • Online ISBN: 978-3-662-47181-4

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