Metastatic Nonfunctioning Pancreatic Neuroendocrine Carcinoma to Liver: Surgical Treatment and Outcomes

Cusati, Daniel; Zhang, Lizhi; Harmsen, William S.; Hu, Amy; Farnell, Michael B.; Nagorney, David M.; Donohue, John H.; Que, Florencia G.; Reid‐Lombardo, Kaye M.; Kendrick, Michael L.

doi:10.1016/j.jamcollsurg.2012.05.002

Cited by 62 publications

(25 citation statements)

References 18 publications

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“…A similar analysis of records of 72 patients with curative ( n = 39) or palliative ( n = 32) resection of pancreatic NETs with hepatic metastases revealed an OS at 1, 5, and 10 years of 97%, 60%, and 45%, respectively [40]. Among the patients with a complete ( R 0) resection, the 1- and 5-year disease-free survival were 53.7% and 10.7%, respectively.…”

Section: Locoregional Therapeutic Optionsmentioning

confidence: 97%

Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature

Neychev

Kebebew

2017

International Journal of Surgical Oncology

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Our understanding of the biology, genetics, and natural history of neuroendocrine tumors (NETs) of the gastrointestinal tract and pancreas has improved considerably in the last several decades and the spectrum of available therapeutic options is rapidly expanding. The management of patients with metastatic low or intermediate grade NETs has been revolutionized by the development of new treatment strategies such as molecular targeting therapies with everolimus and sunitinib, somatostatin analogs, tryptophan hydroxylase inhibitors, and peptide receptor radionuclide therapy that can be used alone or as a multimodal approach with or without surgery. To further define and clarify the utility, appropriateness, and the sequence of the growing list of available therapies for this patient population will require more high level evidence; however, data from well-designed randomized phase III clinical trials is rapidly accumulating that will further stimulate development of new management strategies. It is therefore important to thoroughly review emerging evidence and report major findings in frequent updates, which will expand our knowledge and contribute to a better understanding, characterization, and management of advanced NETs.

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Section: Locoregional Therapeutic Optionsmentioning

confidence: 97%

Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature

Neychev

Kebebew

2017

International Journal of Surgical Oncology

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“…Although the management of stage IV tumors is controversial, some studies have reported a better response to systemic treatment and an increase in the length of disease-free survival in patients where the primary tumor is resected and even after the cytoreduction in advanced nonfunctional tumors (34).…”

Section: Vascular Invasion (N)mentioning

confidence: 99%

A single institutions 21-year experience with surgically resected pancreatic neuroendocrine tumors: an analysis of survival and prognostic factors

et al. 2016

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Background: Pancreatic neuroendocrine tumors (pNETs) comprise a heterogeneous group of tumors with a varied biological behavior. In the present study, we analyzed the experience of 79 pNETs resected between 1993 and 2015. The pathologic prognostic factors (European Neuroendocrine Tumor Society, ENETS; and AJCC) classification, vascular invasion (VI), proliferation index (ki-67) and the presence of necrosis were retrospectively reviewed.Methods: The clinical data of 79 patients with pNETs who underwent surgery were retrospectively analyzed. Mortality rates and Kaplan-Meier estimates were used to evaluate survival over time for pathologic stages, tumor functionality, and vascular invasion. Cox proportional hazards models were used to calculate the hazard ratio regarding ENETS, AJCC staging, sex, tumor functionality and vascular invasion.Results: The male:female ratio was 40:39. Twenty-one patients (26%) had functional tumors and 58 (73.4%) had nonfunctional tumors, of which 35 (44.3%) were diagnosed incidentally. Seventeen Whipple procedures, 46 distal pancreatectomies (including 26 laparoscopic and 20 open procedures), 8 laparoscopic central pancreatectomies, 1 laparoscopic resection of the uncinated process and 7 enucleations (one laparoscopic) were performed. Vascular invasion and necrosis were observed in 29 of 75 cases (38.6%) and in 16 cases (29%), respectively. The comparison between survivor functions of ENETS staging categories showed statistically significant differences (p = 0.042). Mortality rate was higher in patients with non-functioning tumors compared with hormonally functioning tumors (p = 0.052) and in those with vascular invasion (p = 0.186).Conclusions: In spite of the heterogeneity of pNETs, the ENETS TNM classification efficiently predicts long-term prognosis. The non-functioning tumors and the presence of vascular invasion are associated with poor prognosis.

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“…[2][3][4][5][6][7][8][9] Several studies have validated aggressive resection of advanced disease with portal vein tumor thrombosis or hepatic metastases. [10][11][12][13] For non-functional PNETs, irrespective of tumor size, the National Comprehensive Cancer Network guidelines recommend surgical resection, including regional lymph nodes. They state that enucleation or observation are options for small tumors (\10 mm); however, their criteria are unclear.…”

mentioning

confidence: 99%

Basing Treatment Strategy for Non-functional Pancreatic Neuroendocrine Tumors on Tumor Size

Kishi¹,

Shimada²,

Nara³

et al. 2014

Ann Surg Oncol

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Metastatic Nonfunctioning Pancreatic Neuroendocrine Carcinoma to Liver: Surgical Treatment and Outcomes

Cited by 62 publications

References 18 publications

Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature

Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature

A single institutions 21-year experience with surgically resected pancreatic neuroendocrine tumors: an analysis of survival and prognostic factors

Basing Treatment Strategy for Non-functional Pancreatic Neuroendocrine Tumors on Tumor Size

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Metastatic Nonfunctioning Pancreatic Neuroendocrine Carcinoma to Liver: Surgical Treatment and Outcomes

Cited by 62 publications

References 18 publications

Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature

Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature

A single institutions 21-year experience with surgically resected pancreatic neuroendocrine tumors: an analysis of survival and prognostic factors

Basing Treatment Strategy for Non-functional Pancreatic Neuroendocrine Tumors on Tumor Size

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A single institutions 21-year experience with surgically resected pancreatic neuroendocrine tumors: an analysis of survival and prognostic factors