Indications for the Surgical Management of Pancreatic Neuroendocrine Neoplasms

被引:3
作者
Boesch, Florian [1 ]
Belyaev, Orlin [2 ]
Brunner, Maximilian [3 ]
Mueller-Debus, Charlotte Friederieke [4 ]
Radulova-Mauersberger, Olga [5 ]
Gruetzmann, Robert [3 ]
Keck, Tobias [4 ]
Uhl, Waldemar [2 ]
Witzigmann, Helmut [5 ]
Werner, Jens [1 ]
机构
[1] Klinikum Univ Munchen, Klin Allgemein Viszeral Gefass & Transplantat Chi, Munich, Germany
[2] Katholisches Klinikum Bochum, Klin Allgemein & Viszeralchirurg, St Josef Hosp, Bochum, Germany
[3] Univ Klinikum Erlangen, Chirurg Klin, Erlangen, Germany
[4] Univ Klinikum Schleswig Holstein, Klin Chirurg, Campus Lubeck, Lubeck, Germany
[5] Stadt Klinikum Dresden Friedrichstadt, Klin Allgemein & Viszeralchirurg, Dresden, Germany
来源
ZENTRALBLATT FUR CHIRURGIE | 2020年 / 145卷 / 04期
关键词
neuroendocrine neoplasm; pancreas; operative indication; pancreatic surgery; tumour size; ENETS CONSENSUS GUIDELINES; HEPATIC METASTASES; PROGNOSTIC-FACTORS; LIVER METASTASES; TUMORS; SURGERY; RESECTION; ENUCLEATION; SURVIVAL; UPDATE;
D O I
10.1055/a-1168-7103
中图分类号
R61 [外科手术学];
学科分类号
摘要
Neuroendocrine neoplasms of the pancreas (pNEN) have an increasing incidence and prevalence. Thus, this entity is of increasing clinical significance. Patients with pNEN become clinically apparent due to different and unspecific symptoms. Some tumours secrete hormones and peptides and become clinically symptomatic. In general, these tumours can metastasise early and even small tumours lead to distant metastases. Nonetheless, primary tumour size and grading are important prognostic factors. On the basis of a systematic literature research and the formulation of key issues according to the PICO system, therapeutic concepts were established. These concepts were evaluated with a Delphi process among the members of the pancreas research group and the indications for surgery group of the German Society of General and Visceral Surgery. Thus this article gives an overview of the surgical treatment modalities and indications for the treatment of pNEN. Surgery is still the gold standard in treatment and the only potential chance of cure. Surgery is indicated for sporadic as well as hereditary pNEN > 2 cm independent of the functional activity. A so called "wait and see" strategy might be indicated in smaller pNEN; however, there is little evidence for this approach. In this respect, pNEN of 1-2 cm represent a surgical indication. The treatment of hereditary pNEN is challenging and should be interdisciplinary. Even in the case of distant metastases, a curative approach might be feasible and multimodal treatment is indicated.
引用
收藏
页码:365 / 373
页数:9
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