Management of the primary tumor in patients with metastatic pancreatic neuroendocrine tumor: a contemporary single-institution review

Abstract Background Pancreatic nonfunctioning neuroendocrine tumors (PNFNETs) are an uncommon malignancy and often present with metastatic disease. There is a lack of information on the management of the primary tumor in patients who present with unresectable synchronous hepatic metastases. Methods...

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Bibliographic Details
Published in:The American journal of surgery 2009-03, Vol.197 (3), p.376-381
Main Authors: Bruzoni, Matias, M.D, Parikh, Purvi, M.D, Celis, Rolando, M.D, Are, Chandrakanth, M.D, Ly, Quan P., M.D, Meza, Jane L., Ph.D, Sasson, Aaron R., M.D
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Female
Humans
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Male
Middle Aged
Neoplasms, Multiple Primary - surgery
Neuroendocrine Tumors - secondary
Neuroendocrine Tumors - surgery
Pancreatic endocrine tumors
Pancreatic neoplasm
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Pancreatic surgery
Retrospective Studies
Surgery
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Summary:Abstract Background Pancreatic nonfunctioning neuroendocrine tumors (PNFNETs) are an uncommon malignancy and often present with metastatic disease. There is a lack of information on the management of the primary tumor in patients who present with unresectable synchronous hepatic metastases. Methods A retrospective review (2001–2008) of PNFNETs was conducted. Patients were divided into 3 groups: PNFNET without evidence of hepatic metastasis (group A), PNFNET with metastatic disease involving less than 50% of the liver (group B), and PNFNET with metastatic disease involving more than 50% of the liver (group C). Clinical data and outcomes were analyzed. Results Thirty-five patients with PNFNET were identified (group A = 15, group B = 11, group C = 9). Resection of the pancreatic tumor was performed in 26 patients. With a mean follow-up period of 30 months, death from disease progression occurred in 1 patient in group A, none in group B, and in 7 in group C. Conclusions In selected patients, resection of the primary pancreatic tumor even in the setting of unresectable but limited hepatic metastases may be indicated.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2008.11.005