Surgical Management of Pancreatic Neuroendocrine Tumors

Sulciner, Megan L.; Clancy, Thomas E.

doi:10.3390/cancers15072006

Cited by 8 publications

(3 citation statements)

References 155 publications

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“…In functional PNETs, surgical intervention is considered the best approach due to the need for symptom control or potential curative effect. Nonfunctional PNETs, conversely, can be managed non-operatively [13] . The options vary from radiotherapy, chemotherapy, and targeted therapy of all which had shown beneficial effects in reducing tumor growth rate and relapse [14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

Oral primitive neuroectodermal tumor associated with mandibular lymphadenopathy in three-year-old female Indonesian children: A rare case report

Permatasari,

Kurniasih

2023

Int. J. Surg. Sci.

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Introduction: Primitive neuroectodermal tumors (PNETs) are rare and aggressive malignancies derived from primitive neural crest cells in the CNS, with peripheral variants known as peripheral PNETs (pPNETs) found in soft tissues. Diagnosing PNETs is challenging due to their rarity and resemblance to other neoplastic conditions like Ewing's sarcoma and rhabdomyosarcoma. Case Presentation: A 3-year-old female child presented with a growing bump on her lips, causing obstruction of the mouth and both of the nostrils hence impairing daily living. Examination revealed an irregular mass with signs of tissue necrosis and bleeding. A blood test and head CT scan indicated a benign mass, potentially a hemangioma, with submandibular lymphadenopathy and leukocytosis. The patient underwent a debridement procedure and a subsequent operation to excise part of the mass for histopathological analysis. The results revealed a primitive neuroectodermal tumor, specifically a melanotic neuroectodermal tumor of infancy (MNTI). Discussion: Peripheral PNETs are more commonly seen in older individuals with abdominal/pelvic and thoracic-pulmonary lesions being the most frequent. Our case of a 3-year-old Indonesian child with a distinct oral cavity PNET is considered rare among the age and race groups. Conclusion:The case of a three-year-old Indonesian female child with peripheral PNET in the submandibular region is an uncommon presentation in terms of age, tumor location, race, and ethnicity. Clinicians should be aware of such rare possibilities and follow thorough histopathology and immunohistochemistry tests to establish an accurate diagnosis.

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Section: Discussionmentioning

confidence: 99%

Oral primitive neuroectodermal tumor associated with mandibular lymphadenopathy in three-year-old female Indonesian children: A rare case report

Permatasari,

Kurniasih

2023

Int. J. Surg. Sci.

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“…Although the incidence of pNET is signi cantly lower than pancreatic cancer, it has been dramatically increasing nowadays due to improved early detection methods and the popularization of routine physical examination (2)(3). Surgery is still the major treatment modality both for functional pNET to control active hormones-related symptoms and for large non-functional pNET to control local advancement and distant metastasis (4). However, although reoperation may be a good choice, liver metastasis after primary site resection hampers the improvement of overall survival (OS) and leads to a dismal prognosis (5).…”

Section: Introductionmentioning

confidence: 99%

Predicting Liver Metastasis in Pancreatic Neuroendocrine Tumor After Surgery: A Population-Based Study

Wang,

Kong,

Yang

et al. 2023

Preprint

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Background The occurrence of liver metastasis in pancreatic neuroendocrine tumor (pNET) after primary site surgery significantly hampers the improvement of patient’s overall survival (OS). Therefore, it is necessary for early detection of metastatic lesions. However, the relationship between clinical variables and the liver metastasis potential remains obscure. Methods Detailed information of pNET patients received primary site surgery was retrieved from the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2019. Univariate and multivariate logistic regression analysis were recruited to generate independent risk factors of liver metastasis to construct a model presented as a nomogram using training cohort of SEER database. Moreover, a testing cohort from SEER database and a cohort of 96 patients from Second Affiliated Hospital of Zhejiang University School of Medicine were further recruited for internal and external verification respectively. The receiver operating characteristic curve, calibration curve, decision curve analysis (DCA) and clinical impact curve (CIC) were used to evaluate the accuracy, reliability and clinical application value respectively. The risk subgroups were finally generated according to the score of the nomogram. Results 2458 pNET patients were included in the present study. And 1638 of them were assigned as training cohort and 820 of them were assigned as testing cohort. Tumor size, AJCC T stage, functional status and other site metastases were considered as independent risk factors of liver metastasis via multivariate logistic regression analysis (all, p < 0.05). Our nomogram showed an excellent accuracy with the area under curve (AUC) of 0.821 in training cohort, 0.766 in testing cohort and 0.817 in validation cohort, respectively. Moreover, the calibration curve, DCA and CIC indicated a better net benefit and clinical application value in training cohort, testing cohort and validation cohort compared with single variate. Finally, pNET patients could be classified into low, medium and high risk of liver metastasis. Patients with high risk of liver metastasis showed a significant poorer OS compare to other two groups. Conclusion Tumor size can be an important predictor of liver metastasis in pNET patients. The nomogram we established could predict liver metastasis of pNET patients after surgery accurately.

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“…They can be classified into resectable, borderline resectable, and locally advanced tumors according to the stage and surgical possibility ( 3 , 4 ). Among them, borderline resectable and distant metastatic tumors often increase the difficulty of surgery due to invasion of nearby organs or a significant tumor load, including the expansion of the scope of surgery and the inability to achieve radical resection ( 5 ). It is worth noting that there is ongoing debate among surgeons on the survival and symptomatic benefits of surgery for patients with locally advanced and metastatic pNENs, particularly G3 pNETs and pNECs ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Multivisceral resection of nonfunctional pancreatic neuroendocrine neoplasm with nearby organ invasion: a case report

Zhang,

Niu,

et al. 2023

Front. Endocrinol.

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Pancreatic neuroendocrine neoplasms (pNENs) are relatively rare epithelial malignancies originating from pancreatic neuroendocrine cells, pathologically classified into well-differentiated pancreatic neuroendocrine tumors (pNETs) and poorly-differentiated pancreatic neuroendocrine carcinoma (pNECs). Although they also fall under the category of pNENs, the almost entirely distinct biological characteristics and survival prognosis have caused debate among surgeons when it comes to the development of surgical intervention options, particularly for locally advanced G3 pNETs and pNECs. We present a case of 66-year-old male with nonfunctional G3 pNET, invasion of five nearby pancreatic organs and type II liver metastases. The patient achieved good outcomes after undergoing multivisceral resection and postoperative adjuvant chemotherapy. This finding helps surgeons better understand locally advanced pNENs, formulate treatment decisions systematically and confidently, and balance patient benefits and risks of surgery.

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Surgical Management of Pancreatic Neuroendocrine Tumors

Cited by 8 publications

References 155 publications

Oral primitive neuroectodermal tumor associated with mandibular lymphadenopathy in three-year-old female Indonesian children: A rare case report

Oral primitive neuroectodermal tumor associated with mandibular lymphadenopathy in three-year-old female Indonesian children: A rare case report

Predicting Liver Metastasis in Pancreatic Neuroendocrine Tumor After Surgery: A Population-Based Study

Multivisceral resection of nonfunctional pancreatic neuroendocrine neoplasm with nearby organ invasion: a case report

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