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Treatment strategies for borderline resectable pancreatic neuroendocrine tumors: a narrative review.
Chang, Jin Y; Ruff, Samantha M; Cloyd, Jordan M.
Afiliação
  • Chang JY; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.
  • Ruff SM; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA; Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
  • Cloyd JM; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA; Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Chin Clin Oncol ; 13(2): 25, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38711178
ABSTRACT
BACKGROUND AND

OBJECTIVE:

Well-differentiated pancreatic neuroendocrine tumors (pNETs) are a group of rare, heterogeneous tumors that originate in the endocrine tissue of the pancreas and account for 1-2% of all pancreatic neoplasms. The majority of pNETs are non-functional and typically follow a more indolent course. Especially at early stages, the primary management of pNETs is surgical resection which is associated with relatively low rates of recurrence and excellent long-term prognosis. On the other hand, some patients will present with locally advanced primary tumors or low volume metastatic disease in which complete surgical resection may be more difficult to achieve and recurrence rates are significant. Unlike treatment of borderline resectable (BR) pancreatic adenocarcinoma, in which neoadjuvant treatment strategies are becoming standardized, borderline resectability is not a currently established terminology for pNETs and the optimal multidisciplinary treatment approach is poorly understood.

METHODS:

We performed a literature search on PubMed, Google Scholar, and ClinicalTrials.gov using keywords, including 'pancreatic neuroendocrine tumor' and 'borderline resectable'. All studies and review articles in English with full text were considered. Each publication was independently reviewed. KEY CONTENT AND

FINDINGS:

We introduce the concept of BR-pNETs, focusing on important criteria that should be included in their definition by balancing the feasibility of resection and the clinical utility of surgery. We suggest that extended resection, involving vascular reconstruction, adjacent organ resection, and/or liver metastasis, should be considered at experienced, high volume centers. Furthermore, we outline multidisciplinary treatment strategies, including systemic and locoregional treatment options, for optimizing outcomes for this growing patient population.

CONCLUSIONS:

Formalizing the definition of resectability in pNETs through multidisciplinary collaborative research will be important for standardizing the indications for multimodality treatment and aggressive surgical approaches for patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Tumores Neuroendócrinos Limite: Humans Idioma: En Revista: Chin Clin Oncol Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Pancreáticas / Tumores Neuroendócrinos Limite: Humans Idioma: En Revista: Chin Clin Oncol Ano de publicação: 2024 Tipo de documento: Article