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

• 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
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2008.11.005

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.