Pancreatic Neuroendocrine Tumors: Surgical Resection

Belotto, Marcos; Crouzillard, Bruna do Nascimento Santos; Araujo, Karla de Oliveira; Peixoto, Renata D’Alpino

doi:10.1590/0102-672020180001e1428

Cited by 14 publications

(16 citation statements)

References 22 publications

(31 reference statements)

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“…Most series indicate that when a resectable tumor is discovered incidentally, resection results in long-term survival and provides a cure rate of up to 95%. Accurate diagnosis and differentiation from other more aggressive tumors is important 3 , 7 , 13 , 14 , 15 , 17 , 20 , 23 .…”

Section: Discussionmentioning

confidence: 99%

Pancreatoduodenectomy for Solid Pseudopapillary Tumor of the Pancreas: A Multi-Institution Study

Torres

Rezende

Waechter

et al. 2019

ABCD, arq. bras. cir. dig.

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Background: Solid pseudopapillary tumor of the pancreas is a rare low-grade malignant neoplasm. Most patients present with nonspecific symptoms until the tumor becomes large. Complete surgical resection by pancreatoduodenectomy is the treatment of choice for tumors located in the head of the pancreas Aim: To analyzed the clinicopathologic features, management, and outcomes of patients who had solid pseudopapillary tumor of the head pancreas and underwent surgical resection. Methods: Were analyzed 16 patients who underwent pancreatoduodenectomy for this condition. Results: Mean age was 25.7 years old, and 15 patients were female (93.7%). Nonspecific abdominal pain was present in 14 (87.5%). All underwent computed tomography and/or magnetic resonance imaging as part of diagnostic workup. The median diameter of the tumor was 6.28 cm, and surgical resection was performed with open or laparoscopic pancreatoduodenectomy without neoadjuvant chemotherapy. Postoperative complications occurred in six patients (37.5%) and included pancreatic fistula without mortality. The mean of hospital stay was 10.3 days. Median follow-up was 3.6 years, and no patient had local recurrence or metastatic disease. Conclusion: For these patients surgical resection with pancreatoduodenectomy is the treatment of choice showing low morbidity, no mortality, and good long-term survival.

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Section: Discussionmentioning

confidence: 99%

Pancreatoduodenectomy for Solid Pseudopapillary Tumor of the Pancreas: A Multi-Institution Study

Torres

Rezende

Waechter

et al. 2019

ABCD, arq. bras. cir. dig.

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“… 5 , 6 Complete surgical resection of a PNET has been suggested to be the only potentially curative treatment. 7 Recently, the European Neuroendocrine Tumor Society identified that assessment of the effects of surgical treatment for locally advanced PNETs is a major unmet need. 1 …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Outcomes Following Surgery for Locally Advanced Pancreatic Neuroendocrine Tumors

et al. 2020

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Key Points Question What are the outcomes of patients who undergo aggressive resection of locally advanced pancreatic neuroendocrine tumors (PNETs)? Findings In this case series, 99 patients with locally advanced (T3/T4) PNETs and no known distant metastatic disease who underwent resection had a recurrence rate of 35%, but their quality of life remained high, and the overall 5-year survival was 91%. Meaning These findings suggest that locally advanced PNETs warrant aggressive surgical resection, including local organs and blood vessels, if necessitated by tumor invasion.

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“…Thus, the purpose of surveillance and treatment is a matter of debate. They make up 7% of all gastrointestinal NETs and 2% of all excised gastric polyps 3,4,27 . Those in the small intestine, especially those in the duodenum, are increasingly seen in early stages and are easily treated (with a diameter ≤10 mm) 5,15,16,32 .…”

Section: Resultsmentioning

confidence: 99%

The Role of Conventional Echoendoscopy (Eus) in Therapeutic Decisions in Patients With Neuroendocrine Gastrointestinal Tumors

Costa

Kemp

Santos

et al. 2020

ABCD, arq. bras. cir. dig.

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Background: Gastrointestinal neuroendocrine tumors are rare, usually presented as subepithelial or polypoid tumors. Accurate diagnosis and indication of the type of resection are still challenging. Aim: To determine the effectiveness of echoendoscopy in determining the depth of the lesions (T) identified by endoscopy in order to evaluate surgical and/or endoscopic indication, and to evaluate the results of endoscopic removal in the medium term. Methods: Twenty-seven patients were included, all of whom underwent echoendoscopy for TN tumor staging and the evaluation of possible endoscopic resection. The parameters were: lesion size, origin layer, depth of involvement and identified perilesional adenopathies. The inclusion criteria for endoscopic resection were: 1) high surgical risk; 2) those with NET <2 cm; 3) absence of impairment of the muscle itself; and 4) absence of perilesional adenopathies in echoendoscopy and in others without distant metastases. Exclusion criteria were TNE> 2 cm; those with infiltration of the muscle itself; with perilesional adenopathies and distant metastases. The techniques used were: resection with polypectomy loop; mucosectomy with saline injection; and mucosectomy after ligation with an elastic band. The anatomopathological study of the specimens included evaluation of the margins and immunohistochemistry (chromogranin, synaptophysin and Ki 67) to characterize the tumor. Follow-up was done at 1, 6 and 12 months. Results: Resections with polypectomy loop were performed in 15 patients; mucosectomy in five; mucosectomy and ligation with elastic band in three and the remaining four were referred for surgery. The anatomopathological specimens and immunohistochemical analyzes showed positive chromogranin and synaptophysin, while Ki 67 was less than 5% among all cases. The medium-term follow-up revealed three recurrences. The average size of tumors in the stomach was 7.6 mm and in the duodenum 7.2 mm. Well-demarcated, hypoechoic, homogeneous lesions occurred in 75%; mucous layer in 80%; and the deep and submucosal mucosa in 70%. Conclusions: Echoendoscopy proved to be a good method for the study of subepithelial lesions, being able to identify the layer affected by the neoplasm, degree of invasion, echogenicity, heterogeneity, size of the lesion and perilesional lymph node involvement and better indicate the treatment option.

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Pancreatic Neuroendocrine Tumors: Surgical Resection

Cited by 14 publications

References 22 publications

Pancreatoduodenectomy for Solid Pseudopapillary Tumor of the Pancreas: A Multi-Institution Study

Pancreatoduodenectomy for Solid Pseudopapillary Tumor of the Pancreas: A Multi-Institution Study

Evaluation of Outcomes Following Surgery for Locally Advanced Pancreatic Neuroendocrine Tumors

The Role of Conventional Echoendoscopy (Eus) in Therapeutic Decisions in Patients With Neuroendocrine Gastrointestinal Tumors

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