Management of Pancreatic Neuroendocrine Tumors

Pancreatic neuroendocrine tumors secrete hormones that can result in characteristic clinical syndromes; however, most remain clinically silent and are diagnosed at a late stage. Tumor stage and histologic grade are associated with prognosis and help guide therapeutic decisions. Surgical resection is generally attempted in patients with localized disease. In patients with surgically unresectable disease, treatment with somatostatin analogs, hepatic embolization, or cytotoxic chemotherapy may be recommended. Newer targeted therapies have been shown to improve progression-free survival durations and were recently approved for use in patients with advanced pancreatic neuroendocrine tumors, further expanding treatment options for patients with this disease.