| Theme |
Gastroenteropancreatic Neuroendocrine Tumors |
| Title |
Surgical Treatment of Pancreatic Neuroendocrine Tumors |
| Author |
Takao Ohtsuka |
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author |
Junji Ueda |
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author |
Shunichi Takahata |
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author |
Kazuhiro Mizumoto |
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author |
Shuji Shimizu |
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| Author |
Masao Tanaka |
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University |
| [ Summary ] |
All pancreatic neuroendocrine tumors (PNETs) including small asymptomatic tumors, are candidates for resection. Surgical procedures range from enucleation to atypical partial pancreatectomy. Further treatment may be provided with standard pancreatectomy and regional lymph node dissection, based on the malignancy potential of the tumors. However, it is difficult to predict the precise pathological grade of PNETs preoperatively. The Japanese insurance system has allowed the use of laparoscopic surgery for pancreatic tumors including PNETs since April, 2012. This procedure will be used for most PNETs with low malignancy potential in the near future. On the other hand, for patients having multiple PNETs caused by multiple endocrine neoplasia I, pancreas-preserving resection should be pursued to avoid total pancreatectomies. Hepatic metastasis is also an indication for surgery, whenever resection is possible. Even for patients with unresectable hepatic metastases, multidisciplinary therapy including reduction surgery to reduce over 90 % of tumor volume may provide improved long-term survival rates. |