Surgery in malignant pancreatic neuroendocrine tumors

Nguyen, Scott Q.; Angel, Luz P.; Divino, Celia M.; Schluender, Stefanie; Warner, Richard R.P.

doi:10.1002/jso.20824

Cited by 64 publications

(55 citation statements)

References 27 publications

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“…The overall survival data did not differ significantly in the two studies (56,58), whereas the third study (57) did not report data on overall survival. Nevertheless, the 5-year survival rate seemed generally higher in patients who had their primary tumor resected, with a difference of 30% in one study, of 33% in a second (57), and no difference in a third study (56). Given the absence of randomization in the examined studies, a bias toward a more aggressive approach in patients with a better overall performance status, a less advanced disease, or possibly with location of the tumor in the body or tail of the pancreas seems likely.…”

Section: Surgery Of Primary Tumormentioning

confidence: 81%

“…Indeed, while ENETS suggests the removal of the primary tumor to make the only persisting problem for intestinal NETs (30), the resection of the primary tumor in metastatic pancreatic NETs is not recommended, except for selected low-risk patients with life-threatening symptoms due to complications (5 (56,57,58), one prospective study with a relatively small sample size and an other two retrospective studies. The overall survival data did not differ significantly in the two studies (56,58), whereas the third study (57) did not report data on overall survival. Nevertheless, the 5-year survival rate seemed generally higher in patients who had their primary tumor resected, with a difference of 30% in one study, of 33% in a second (57), and no difference in a third study (56).…”

Section: Surgery Of Primary Tumormentioning

confidence: 99%

See 1 more Smart Citation

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

Partelli

Maurizi

Tamburrino

et al. 2014

European Journal of Endocrinology

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The incidence of neuroendocrine tumors (NETs) has increased in the last decades. Surgical treatment encompasses a panel of approaches ranging from conservative procedures to extended surgical resection. Tumor size and localization usually represent the main drivers in the choice of the most appropriate surgical resection. In the presence of small (!2 cm) and asymptomatic nonfunctioning NETs, a conservative treatment is usually recommended. For localized NETs measuring above 2 cm, surgical resection represents the cornerstone in the management of these tumors. As they are relatively biologically indolent, an extended resection is often justified also in the presence of advanced NETs. Surgical options for NET liver metastases range from limited resection up to liver transplantation. Surgical choices for metastatic NETs need to consider the extent of disease, the grade of tumor, and the presence of extra-abdominal disease. Any surgical procedures should always be balanced with the benefit of survival or relieving symptoms and patients' comorbidities.

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Section: Surgery Of Primary Tumormentioning

confidence: 81%

Section: Surgery Of Primary Tumormentioning

confidence: 99%

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

Partelli

Maurizi

Tamburrino

et al. 2014

European Journal of Endocrinology

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“…Of the 4 studies potentially appropriate to be included in the review [11,15,16,17], 3 were excluded because they did not contain sufficient data for the two treatment arms [11,16,17]. Two additional studies were found by hand searching/search of references of the identified papers [18,19], leaving 3 studies with usable information, by outcome, analysed in detail [15,18,19]. Agreement for these studies was 100% among the two reviewers.…”

Section: Resultsmentioning

confidence: 99%

Role of Resection of the Primary Pancreatic Neuroendocrine Tumour Only in Patients with Unresectable Metastatic Liver Disease: A Systematic Review

et al. 2011

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Background: Surgery remains the only curative option for pancreatic neuroendocrine tumours (PNETs), but its indication is limited by metastatic disease in most patients. Indication for removing the primary lesion only in the setting of unresectable liver disease is controversial. The present systematic review aims at determining the potential bene- fits (survival, progression-free survival) or harms (morbidity, mortality) of surgical resection of the primary lesion only in patients with PNETs and unresectable metastases. Meth ods: Medline was queried for studies reporting the outcome of PNET patients with unresectable liver metastases whenever there was an explicit comparison between resection of the primary lesion only (‘active treatment’) and no resection (‘non-active treatment’). The primary outcome was survival; possible secondary outcomes were progression-free survival, treatment-related mortality and morbidity, and relief of symptoms. Results: Only 3 cohort studies found were eligible and analysed; no meta-analysis could be performed. The number of patients undergoing ‘active treatment’ varied from 16 to 20, with a percentage ranging from 17 to 39% of cohorts. Survival was longer in patients who received ‘active treatment’ in 2 studies, and the 5-year survival rate also seemed higher, without significant complications. Discussion: Available data suggest a possible benefit of resection of the primary lesion only in this setting. However, a bias towards a more aggressive surgical approach in patients with a better performance status or less advanced disease seems likely, and no conclusion can be drawn except for the need of randomised trials. We calculated that such a trial would require at least 118 patients per arm.

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“…28.3-77% of patients with PNET develop liver metastasis during the course of their disease (36,37). In managing NET with liver metastasis, surgery helps in reducing tumor burden and hormonal secretion in functioning tumor (38,39). If liver metastasis is left untreated, 5-year survival was only 30-40% (40,41).…”

Section: Management With Liver Metastasismentioning

confidence: 99%

Role of surgery in pancreatic neuroendocrine tumor

2018

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Surgery in malignant pancreatic neuroendocrine tumors

Abstract: Patients with malignant pancreatic neuroendocrine tumors commonly present with advanced disease. Although, curative resection is not frequent, survival benefit may be obtainable with aggressive surgical management even in the face of metastatic disease.

Cited by 64 publications

References 27 publications

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

Role of Resection of the Primary Pancreatic Neuroendocrine Tumour Only in Patients with Unresectable Metastatic Liver Disease: A Systematic Review

Role of surgery in pancreatic neuroendocrine tumor

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