Surgery in Zollinger-Ellison Syndrome Alters the Natural History of Gastrinoma

Fraker, Douglas L.; Norton, Jeffrey A.; Alexander, H. Richard; Venzon, David; Jensen, Robert T.

doi:10.1097/00000658-199409000-00008

Cited by 180 publications

(110 citation statements)

References 19 publications

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“…At least one study (6) that retrospectively analyzed the effect of surgical exploration in patients with large pancreatic PETs with MEN1 concluded that surgery did not prevent the development of hepatic metastases and extend survival. However, a recent study (58) in patients with primarily sporadic gastrinomas provided evidence that early surgical resection of the primary tumor decreased the probability of developing hepatic metastases. A second possibility would be to consider treating patients with aggressively growing PETs with MEN1 with a long-acting somatostatin analog (octreotide, lanreotide).…”

Section: Discussionmentioning

confidence: 99%

Prospective Study of the Natural History of Gastrinoma in Patients with MEN1: Definition of an Aggressive and a Nonaggressive Form

Gibril

Venzon

Ojeaburu

et al. 2001

The Journal of Clinical Endocrinology &Amp; Metabolism

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118

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Section: Discussionmentioning

confidence: 99%

Prospective Study of the Natural History of Gastrinoma in Patients with MEN1: Definition of an Aggressive and a Nonaggressive Form

Gibril

Venzon

Ojeaburu

et al. 2001

The Journal of Clinical Endocrinology &Amp; Metabolism

Self Cite

118

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“…On the contrary, other authors suggest a surgical treatment for tumors O3 cm in size or when a biochemical diagnosis is unequivocal (92,93). Nevertheless, patients who are conservatively treated have a risk of LM of 23-29% compared with 3-5% of those patients who undergo radical surgery (94,95). The extension of surgery in these patients is also a matter of debate.…”

Section: Surgery Of Nets In Multiple Endocrine Neoplasia Type 1 Patientsmentioning

confidence: 99%

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

Partelli

Maurizi

Tamburrino

et al. 2014

European Journal of Endocrinology

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The incidence of neuroendocrine tumors (NETs) has increased in the last decades. Surgical treatment encompasses a panel of approaches ranging from conservative procedures to extended surgical resection. Tumor size and localization usually represent the main drivers in the choice of the most appropriate surgical resection. In the presence of small (!2 cm) and asymptomatic nonfunctioning NETs, a conservative treatment is usually recommended. For localized NETs measuring above 2 cm, surgical resection represents the cornerstone in the management of these tumors. As they are relatively biologically indolent, an extended resection is often justified also in the presence of advanced NETs. Surgical options for NET liver metastases range from limited resection up to liver transplantation. Surgical choices for metastatic NETs need to consider the extent of disease, the grade of tumor, and the presence of extra-abdominal disease. Any surgical procedures should always be balanced with the benefit of survival or relieving symptoms and patients' comorbidities.

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“…Fraker et al (33) reported that gastrinoma patients administered conservative treatment exhibited a higher risk of liver metastasis (23%) compared with those who received surgery (3%). In the present study, of the 17 cases, 11 patients underwent surgery and 6 patients received conservative therapy due to metastasis or patient choice.…”

Section: Discussionmentioning

confidence: 99%

Clinical treatment of gastrinoma: A case report and review of the literature

et al. 2016

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Abstract. Gastrinoma is a gastrin-secreting tumor that is associated with Zollinger-Ellison syndrome. The majority of cases occur in the pancreas, followed by the duodenum. Early diagnosis is difficult due to the relative rarity of the tumor and the lack of specific symptoms. In the current study, a 68-year-old female patient presented at the Second Affiliated Hospital, Zhejiang University (Hangzhou, China) due to intermittent abdominal pain and watery diarrhea. The patient was treated by surgical resection and was pathologically diagnosed with a well-differentiated pancreatic neuroendocrine tumor (gastrinoma; grade 1). No evidence of recurrence was observed during 1 year of follow-up. Furthermore, a review of the Chinese literature was performed, which analyzed an additional 17 published cases of gastrinoma. The tumor size ranged between 0.5x0.5 cm and 7.5x6.3x5.1 cm. The pancreas was the most common site of occurrence, accounting for 72% (13/18) of cases, followed by the duodenum (28%; 5/18). The most common initial symptom was abdominal pain (89%; 16/18), followed by diarrhea (56%; 10/18). In 18 cases, including the present case and 17 previous cases, the level of gastrin ranged between 137 and 1,550 pg/ml (normal range, 5-100 pg/ml). Of the 17 previous cases, 11 patients underwent surgery and 6 patients received conservative therapy due to metastasis or patient choice. Overall, gastrinoma remains a rare disease. Complete removal of the lesion is the standard curative treatment and conservative treatment is only recommended for patients unsuitable for surgery or for those with widespread metastasis.

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Surgery in Zollinger-Ellison Syndrome Alters the Natural History of Gastrinoma

Abstract: For the patient with Zollinger-Ellison syndrome without metastatic disease, surgical exploration with attempted curative gastrinoma resection is recommended because it may alter the natural history of this syndrome.

Cited by 180 publications

References 19 publications

Prospective Study of the Natural History of Gastrinoma in Patients with MEN1: Definition of an Aggressive and a Nonaggressive Form

Prospective Study of the Natural History of Gastrinoma in Patients with MEN1: Definition of an Aggressive and a Nonaggressive Form

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

Clinical treatment of gastrinoma: A case report and review of the literature

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