Role of surgery in pancreatic neuroendocrine tumor

Wong, Kai Pun; Tsang, Julia Y. S.; Lang, Brian Hung‐Hin

doi:10.21037/gs.2017.12.05

Cited by 20 publications

(21 citation statements)

References 47 publications

(56 reference statements)

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“…Recurrence of symptoms occurs in the first 5 years after surgery in the majority of patients [ 42 ]. Reported rates of complications and mortality are considered acceptable [ 12 , 42 , 44 – 46 , 58 – 60 ]. If > 75% of the liver parenchyma is involved, prognosis is considered unfavorable and surgical treatment should be avoided [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

Treatment options for PNET liver metastases: a systematic review

Nigri

Petrucciani

Debs³

et al. 2018

World J Surg Onc

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BackgroundPancreatic neuroendocrine tumors (PNETs) are rare pancreatic neoplasms. About 40–80% of patients with PNET are metastatic at presentation, usually involving the liver (40–93%). Liver metastasis represents the most significant prognostic factor. The aim of this study is to present an up-to-date review of treatment options for patients with liver metastases from PNETs.MethodsA systematic literature search was performed using the PubMed database to identify all pertinent studies published up to May 2018.ResultsThe literature search evaluated all the therapeutic options for patients with liver metastases of PNETs, including surgical treatment, loco-regional therapies, and pharmacological treatment. All the different treatment options showed particular indications in different presentations of liver metastases of PNET. Surgery remains the only potentially curative therapeutic option in patients with PNETs and resectable liver metastases, even if relapse rates are high. Efficacy of medical treatment has increased with advances in targeted therapies, such as everolimus and sunitinib, and the introduction of radiolabeled somatostatin analogs. Several techniques for loco-regional control of metastases are available, including chemo- or radioembolization.ConclusionsTreatment of patients with PNET metastases should be multidisciplinary and must be personalized according to the features of individual patients and tumors.

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Section: Resultsmentioning

confidence: 99%

Treatment options for PNET liver metastases: a systematic review

Nigri

Petrucciani

Debs³

et al. 2018

World J Surg Onc

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“…Sporadic pancreatic neuroendocrine tumours (PanNETs) are rare, slow-growing lesions seen in the older patients (50–70 years). As the natural history involves liver metastasis in 80% over time, resection of PanNETs is the treatment of choice 3 10…”

Section: Discussionmentioning

confidence: 99%

“…Hence, asymptomatic tumours >2 cm, functioning tumours and tumours with aggressive features like pancreatic dilation should be resected 10. European Neuroendocrine Tumour Society (ENETS) guidelines recommend non-functioning, low grade, PanNETs <2 cm be followed by active radiological surveillance 12…”

Section: Discussionmentioning

confidence: 99%

Interesting pancreatic tumour in the background of Tuberous Sclerosis

Amarjothi¹,

Jesudason

Ramasamy

et al. 2019

BMJ Case Rep

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Tuberous Sclerosis Complex (TSC) is easily discernible by a myriad of manifestations, most notably dermatological. It is associated with well known and recognised intra-abdominal tumours like angiomyolipoma of the kidney. However, rarer tumours like pancreatic neuroendocrine tumours can occur in the setting of TSC. A high index of suspicion is necessary to identify and treat these lesions early in their natural course. Early identification augurs well with complete surgical excision and excellent survival.

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“…For pNET patients with liver metastasis, resection may achieved improved overall survival if lesions can be completely removed, [3][4][5] and for patients with smallsized tumor, partial pancreatectomy may gain a lower complication rate and a significantly higher overall survival when compared with aggressive surgery approach. [4,6] In addition, follow-up with surveillance may be an alternative for patients with nonfunctioning tumor less than 2 cm in diameter.…”

mentioning

confidence: 99%

“…[4,6] In addition, follow-up with surveillance may be an alternative for patients with nonfunctioning tumor less than 2 cm in diameter. [3][4] Given the fact that pNET had a higher resectability and relatively better prognosis, it would be important to differentiate pNET from PAC prior to surgical treatment. [7] The characterized imaging feature of pNET is hyper-enhancement, whereas PAC often shows hypovascular and desmoplastic.…”

mentioning

confidence: 99%

Value of Texture Analysis of Intravoxel Incoherent Motion Parameters in Differential Diagnosis of Pancreatic Neuroendocrine Tumor and Pancreatic Adenocarcinoma

Wang

Zhang

Wang

et al. 2019

cmsj

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Objective To evaluate the value of texture features derived from intravoxel incoherent motion (IVIM) parameters for differentiating pancreatic neuroendocrine tumor (pNET) from pancreatic adenocarcinoma (PAC). Methods Eighteen patients with pNET and 32 patients with PAC were retrospectively enrolled in this study. All patients underwent diffusion-weighted imaging with 10 b values used (from 0 to 800 s/mm 2). Based on IVIM model, perfusion-related parameters including perfusion fraction (f), fast component of diffusion (D fast) and true diffusion parameter slow component of diffusion (D slow) were calculated on a voxel-by-voxel basis and reorganized into gray-encoded parametric maps. The mean value of each IVIM parameter and texture features [Angular Second Moment (ASM), Inverse Difference Moment (IDM), Correlation, Contrast and Entropy] values of IVIM parameters were measured. Independent sample t-test or Mann-Whitney U test were performed for the betweengroup comparison of quantitative data. Regression model was established by using binary logistic regression analysis, and receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency. Results The mean f value of the pNET group were significantly higher than that of the PAC group (27.0% vs. 19.0%, P = 0.001), while the mean values of D fast and D slow showed no significant differences between the two groups. All texture features (ASM, IDM, Correlation, Contrast and Entropy) of each IVIM parameter showed

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Role of surgery in pancreatic neuroendocrine tumor

Cited by 20 publications

References 47 publications

Treatment options for PNET liver metastases: a systematic review

Treatment options for PNET liver metastases: a systematic review

Interesting pancreatic tumour in the background of Tuberous Sclerosis

Value of Texture Analysis of Intravoxel Incoherent Motion Parameters in Differential Diagnosis of Pancreatic Neuroendocrine Tumor and Pancreatic Adenocarcinoma

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