Abstract
Non-functioning pancreatic neuroendocrine tumors account for 2% of all pancreatic malignancies, most of them are benign and sporadic. The most common image studies for their characterization are CT, MRI, endoscopic ultrasound, and PET. Serum Chromogranine A is the most common tumor marker for PNETs and it is used for the diagnosis as well as for surveillance. Surgical resection, either open or laparoscopic is the treatment of choice for all symptomatic sporadic tumors as well as for malignant tumors in the absence of extra pancreatic extension, lymph node or hepatic metastases.
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Massironi S, Sciola V, Peracchi M, Ciafardini C, Spampatti MP, Conte D. Neuroendocrine tumors of the gastro-entero-pancreatic system. World J Gastroenterol. 2008;14(35):5377–84.
Kulke MH, Anthony LB, Bushnell DL, de Herder WW, Godsmith SJ, Klimstra DS, et al. NANETS treatment guidelines: well-differenciated neuroendocrine tumors of the stomach and pancreas. Pancreas. 2010;39(6):735–52.
Franko J, Weantao F, Genovese E, Moser J. Non functional neuroendocrine carcinoma of the páncreas: incidence, tumor biology and outcomes in 2158 patients. J Gastrointest Surg. 2009;14(3):541–8.
Herrera MF, Akerstrom G, Angelos P, Grant CS, Hoff AO, Pantoja JP, et al. AACE/ACE disease state clinical review: pancreatic neuronedocrine incidentalomas. Endocr Pract. 2015;21:546–53.
Yao JC, Hassan M, Phan A, et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26(18):3063.
Kent RB, Van Heerden JA, Weiland LH. Nonfuctionning islet cell tumors. Ann Surg. 1981;193:185–90.
Bilimoria KY, Tomlinson JS, Merkow RP. Clinocopathologic features and treatment trends of pancreatic neuroendocrine tumors: analysis of 9821 patients. J Gastrointest Surg. 2007;11:1460–7.
Falconi M, Barstsch DF, Eriksson B, et al. ENETS concensus guidelines for the management of patients with digestive neuroendocrine neoplasm of the digestive system: well differenciated pancreatic non-functionning tumors. Neuroendocrinology. 2012;95:120–34.
Halfdanarson TR, Rabe KG, Rubin J, et al. Pancreatic neuroendocrine tumors (PNETs): incidence, prognosis and recent trend toward improved survival. Ann Oncol. 2008;19(10):1727–33.
Yan M, Zeng L, Zhang Y, et al. Surgical treatment and clinical outcomes of nonfunctional pancreatic neuroendocrine tumors. A 14 year experience from a single center. Medicine. 2014;93(22):1–7.
Klimstra DS, Modlin IR, Coppola D, et al. The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. Pancreas. 2010;39:707–12.
Gullo L, Migliori M, Falconi M, et al. Nonfunctioning pancreatic tumors: a multicenter clínical study. Am J Gastroent. 2003;98(11):2435–9.
Phan GQ, Yeo CJ, Hruban RH, et al. Surgical experience with pancreatic and peripancreatic neuroendocrine tumors: review of 125 patients. J Gastrointest Surg. 1998;2(5):473–82.
Kuo J, Lee J, Chabot J. Nonfunctional pancreatic neuroendocrine tumors. Surg Clin North Am. 2014;94(3):689–708.
Kartalis N, Pozzi RM, Sundin A. Recent developments in imaging of pancreatic neuroendocrine tumors. Ann Gastroenterol. 2015;28(2):193–202.
Hochwald S, Conlon K, Brennan M. Nonfunctional pancreatic islet cell tumors. In: Doherty G, Skogseid B, editors. Surgical endocrinology. Philadelphia: Lippincot Williams &Wilkins; 2001. p. 362–73.
Sundin A, Vullierme MP, Kaltsas G, et al. ENETS consensus guidelines for the standards of care in neuroendocrine tumors: radiological examinations. Neuroendocrinology. 2009;90(2):167–83.
Chatzipantelis P, Salla C, Konstantinou P, et al. Endoscopic ultrasound-guided fine-needle aspiration cytology of pancreatic neuroendocrine tumors: a study of 48 cases. Cancer. 2008;114(4):255–62.
Miderer M, Weber MM, Fottner C. Molecular imaging of gastroenteropancreatic neuroendocrine tumors. Gastroenterol Clin N Am. 2010;39:923–35.
Ter-Minassian M, Chan J, Hooshmand S, et al. Clinial presentation, survival and recurrence in patients with neuroendocrine tumors: results from a prospective institutional database. Endocr Relat Cancer. 2013;20:187–96.
Bettini R, Boninsegna L, Mantovani W, et al. Prognostic factors at diagnosis and value of WHO classification in a mono-institutional series of 180 non functioning pancreatic endocrine tumors. Ann Oncol. 2008;19:903–8.
Touzios JG, Kiely JM, Pitt SC, et al. Neuroendocrine hepatic metastases: does aggressive management improve survival? Ann Surg. 2005;241:776–85.
Lee LC, Grant CS, Salomao DR, et al. Small, nonfunctioning, asymptomatic pancreatic neuroendocrine tumors (PNETs): role of non-operative management. Surgery. 2012;152:965–74.
Sallinen V, Haglund C, Sepannen H. Outcomes of resected nonfunctional pancreatic neuroendocrine tumors: do size and symptoms matter? Surgery. 2015;158(6):1556–63.
Gaujoux S, Partelli S, Maire F, et al. Observational study of natural history of small sporadic nonfuntioning pancreatic neuroendocrine tumors. J Clin Endocrinol Metab. 2013;98(12):4784–9.
Zhang IY, Fernandez-del Castillo C, Zhao J, et al. Operative vs. non-operative management of nonfunctioning pancreatic neuroendocrine tumors. In: 49th annual meeting of the pancreas club syllabus. 2015. p. S001.
Falconi M, Plockinger U, Kwekkemboom D, et al. Well differenciated pancreatic nonfunctioning tumors/carcinoma, ENETS guidelines. Neuroendocrinology. 2006;84:196–211.
Kim MJ, Choi DW, Heo JS, et al. Surgical strategies for nonfunctioning pancreatic neuroendocrine tumors. Br J Surg. 2012;99:1562–8.
Sharpe SM, In H, Winchester DJ, Talamonti MS, et al. Surgical resection provides an overall survival benefit for patients with small pancreatic neuroendocrine tumors. J Gastrointest Surg. 2015;19:117–23.
Solorzano CC, Lee JE, Pisters PWT, et al. Nonfunctioning islet cell carcinoma of the páncreas: survival results in a contemporary series of 163 patiens. Surgery. 2011;130:1078–85.
Toumpanakis C, Meyer T, Caplin ME. Citotoxic treatment including embolization/chemoembolization for neuroendocrine tumors. Best Pract Res Clin Endocrinol Metab. 2007;21:131.
Moertel CG, Lefkopoulo M, Lipsitz S, et al. Streptozocina-doxorubicina, streptozocina-fluoracil or chlorozotocina in the treatment of advanced islet cell carcinoma. N Engl J Med. 1992;326:519–23.
Moertel CG, Kvols LK, Oconnell MJ, et al. Treatment of neuroendocrine carcinoma with combined etoposide and cisplatin. Cancer. 1991;68:227.
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Cordón-Fernández, C.R., Herrera, M.F. (2018). Surgery Versus Observation for Asymptomatic Nonfunctioning Pancreatic Neuroendocrine Tumors. In: Angelos, P., Grogan, R. (eds) Difficult Decisions in Endocrine Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-92860-9_34
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DOI: https://doi.org/10.1007/978-3-319-92860-9_34
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