Surgical management of non-functioning pancreatic neuroendocrine tumors

Shatveryan, G A; Karagyozyan, G A; Chardarov, N K; Bagmet, N N; Ratnikova, N P

doi:10.17116/hirurgia201814-9

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…Without surgery, the OS rate was reduced to 28.4% after 10 years. Surgical treatment of G1 and G2 PNET is recommended in case of resectable primary tumors [22]. While symptoms caused by hormone secretion justifies the resection for functional PNEN-independent from tumor size, non-functional PNEN demand a more differentiated approach including observational strategies for tumors \ 1-2 cm, parenchyma-sparing resection and radical resection.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Assessment of Non‐functioning Neuroendocrine Pancreatic Neoplasms as a Basis for Risk‐Adapted Resection Strategies

et al. 2019

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Background In contrast to exocrine pancreatic carcinomas, prognosis and treatment of pancreatic neuroendocrine neoplasms (PNEN) are significantly different. The variable growth pattern and associated clinical situation of functioning and non-functioning PNEN demand an individualized surgical approach. However, due to the scarce evidence associated with the rare disease, guidelines lack detailed recommendations for indication and for the required extent of surgical resection. Methods In a retrospective single-center study from 1990 to 2018, 239 patients with PNEN were identified. Clinical data were collected in the MaDoc database of the University Medical Center Mainz. A total of 155 non-functional PNEN were selected for further analysis. Results According to the classification of NET by the WHO in 2017, 28.8% (n = 40) of the tumors were G1, 61.9% (n = 86) G2, and 9.4% (n = 13) G3. In 73 patients, hepatic metastases were present. Sixty patients had lymph node metastasis. An R0 resection was achieved in 98 cases, an R1 situation in 10 cases. Five times, a tumor debulking was carried out (R2) and 5 times the operation was aborted without any resection because of the advanced tumor stage. A relapse occurred in 29 patients. Different prognostic factors (grade, tumor size, age) were analyzed. Grade-dependent 10-year overall survival rates were 79.5% (grade 1) and 60.1% (grade 2), respectively. The survival rate of grade 3 patients was limited to 66.7% after 13 months. Conclusion In our study, patients with non-functioning PNEN had a longer overall survival after successful R0 resection. The risk analysis confirmed a Ki-67 cutoff value of 5%, which divided a high-and low-risk group. Patients with a PNEC G3 (Ki-67 index [ 50%) had a very poor prognosis.Neuroendocrine neoplasms (NEN) are rare tumors, with an incidence of 5 per 100,000 persons per year, although autopsy reports estimate their prevalence to be much higher [1-3]. Recent advances in medical technology have resulted in an increased incidence of pancreatic neuroendocrine neoplasms (PNEN) [4]. PNEN represent approximately 3% of pancreatic malignancies. About 50-55% of them are This paper was presented as an oral presentation at the IAES meeting/ 48th World Congress of Surgery August 11-15, 2019 in Krako ´w, Poland.

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Section: Discussionmentioning

confidence: 99%

Prognostic Assessment of Non‐functioning Neuroendocrine Pancreatic Neoplasms as a Basis for Risk‐Adapted Resection Strategies

et al. 2019

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“…Опухоль развивается из отдельных опухолевых клеток, оставшихся в зоне опухолевого поля. Рецидивы опухоли иногда возникают из ближайших лимфогенных метастазов, которые не были удалены во время операции [13][14][15][16][17].…”

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Toxoplasma Gondii as a Factor of Progression of Carcinogenic Processes at the Molecular-Genetic Level in an Intermediate Host

Pashinskaya¹,

Семенов²

2021

Vestnik VSMU

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Objectives. To study Toxoplasma gondii as a factor of carcinogenic processes progression at the molecular-genetic level in an intermediate host. Material and methods. In the experiment, the expression of the proto-oncogenes survivin (BIRC5), epidermal growth factor (ErbB-2/HER2-Neu), GLI, vascular endothelial growth factor (VEGF) and anti-oncogene TP53 was determined in comparison with the reference genes - β-actin (ACTB) and GAPDH by means of PCR analysis in the tissues of animals with C6 tumor in situ infected with toxoplasma in different doses. A statistical comparison was made between the data of the experimental groups, depending on the dose of infection and the stage of the parasite development. Results. It has been revealed that toxoplasma can cause an increase in the expression of survivin (BIRC5), VEGF, ErbB-2/HER2-Neu, GLI in the tumors, lungs, liver, spleen, brain, both when invaded at a dose of 25 toxoplasma tachyzoites per 1 g of body weight (5000 tachyzoites per female) and when infected at a dose of 50 toxoplasma tachyzoites per 1 g of body weight (10000 tachyzoites per female). The degree of an increased expression of proto-oncogenes is directly dependent on the dose and stage of the parasite development. Infection of female rats having glioma with toxoplasma tachyzoites leads to a decrease in the expression of the anti-oncogene TP53 in the tissues of glioma, the lungs, liver, spleen, and brain of female rats. The decrease in the expression of TP53 depends on the dose of infection and the stage of toxoplasma development. Conclusions. Experimental toxoplasmosis causes an increase in the expression of BIRC5, ErbB-2/HER2-Neu, GLI, VEGF and a decrease in the expression of the anti-oncogene TP53, which can lead to the development of aggressive blastomogenic processes in mammalian tissues.

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Surgical management of non-functioning pancreatic neuroendocrine tumors

Cited by 2 publications

References 25 publications

Prognostic Assessment of Non‐functioning Neuroendocrine Pancreatic Neoplasms as a Basis for Risk‐Adapted Resection Strategies

Prognostic Assessment of Non‐functioning Neuroendocrine Pancreatic Neoplasms as a Basis for Risk‐Adapted Resection Strategies

Toxoplasma Gondii as a Factor of Progression of Carcinogenic Processes at the Molecular-Genetic Level in an Intermediate Host

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