Abstract
Pancreatic neuroendocrine tumors (PNETs) are tumors that arise from hormone-secreting cells of the islets of Langerhans; however, not all tumors will be associated with a clinical syndrome of hormonal hypersecretion. Surgical intervention is guided by overarching principles of functioning/nonfunctioning tumors, extent of disease, and location of the tumor. Even in the setting of advanced disease including hepatic metastasis, surgical intervention may be appropriate and can provide durable periods of disease-free survival. In addition, recent molecular characterization of PNETs has allowed the identification of newer systemic therapies with improving efficacy.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Lawrence B, Gustafsson BI, Chan A, Svejda B, Kidd M, Modlin IM. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am. 2011;40(1):1–18, vii.
Johanson V, Tisell LE, Olbe L, Wängberg B, Nilsson O, Ahlman H. Comparison of survival between malignant neuroendocrine tumours of midgut and pancreatic origin. Br J Cancer. 1999;80(8):1259–61.
Muniraj T, Vignesh S, Shetty S, Thiruvengadam S, Aslanian HR. Pancreatic neuroendocrine tumors. Dis Mon. 2013;59(1):5–19.
Ito T, Igarashi H, Jensen RT. Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances. Best Pract Res Clin Gastroenterol. 2012;26(6):737–53.
Sharma J, Duque M, Saif MW. Emerging therapies and latest development in the treatment of unresectable pancreatic neuroendocrine tumors: an update for clinicians. Therap Adv Gastroenterol. 2013;6(6):474–90.
Hernandez-Jover D, Pernas JC, Gonzalez-Ceballos S, Lupu I, Monill JM, Pérez C. Pancreatoduodenal junction: review of anatomy and pathologic conditions. J Gastrointest Surg. 2011;15(7):1269–81.
Chu Q, Al-Kasspooles M, Smith J, et al. Is glucagonoma of the pancreas a curable disease? Int J Gastrointest Cancer. 2001;29(3):155–62.
Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471–4.
Mirallié E, Pattou F, Malvaux P, et al. Value of endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localization of insulinomas and gastrinomas. Experience of 54 cases. Gastroenterol Clin Biol. 2002;26(4):360–6.
Zhou C, Zhang J, Zheng Y, Zhu Z. Pancreatic neuroendocrine tumors: a comprehensive review. Int J Cancer. 2012;131(5):1013–22.
Rufini V, Calcagni ML, Baum RP. Imaging of neuroendocrine tumors. Semin Nucl Med. 2006;36(3):228–47.
Strosberg JR, Coppola D, Klimstra DS, et al. The NANETS consensus guidelines for the diagnosis and management of poorly differentiated (high-grade) extrapulmonary neuroendocrine carcinomas. Pancreas. 2010;39(6):799–800.
Tseng WH, Canter RJ, Bold RJ. Perioperative outcomes for open distal pancreatectomy: current benchmarks for comparison. J Gastrointest Surg. 2011;15(11):2053–8.
Kooby DA, Hawkins WG, Schmidt CM, et al. A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg. 2010;210(5):779–85. 786–777.
Lee LC, Grant CS, Salomao DR, et al. Small, nonfunctioning, asymptomatic pancreatic neuroendocrine tumors (PNETs): role for nonoperative management. Surgery. 2012;152(6):965–74.
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):3063–72.
Moertel CG, Lefkopoulo M, Lipsitz S, Hahn RG, Klaassen D. Streptozocin-doxorubicin, streptozocin-fluorouracil or chlorozotocin in the treatment of advanced islet-cell carcinoma. N Engl J Med. 1992;326(8):519–23.
Cheng PN, Saltz LB. Failure to confirm major objective antitumor activity for streptozocin and doxorubicin in the treatment of patients with advanced islet cell carcinoma. Cancer. 1999;86(6):944–8.
Casanovas O, Hicklin DJ, Bergers G, Hanahan D. Drug resistance by evasion of antiangiogenic targeting of VEGF signaling in late-stage pancreatic islet tumors. Cancer Cell. 2005;8(4):299–309.
Fjällskog ML, Hessman O, Eriksson B, Janson ET. Upregulated expression of PDGF receptor beta in endocrine pancreatic tumors and metastases compared to normal endocrine pancreas. Acta Oncol. 2007;46(6):741–6.
Raymond E, Dahan L, Raoul JL, et al. Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med. 2011;364(6):501–13.
von Wichert G, Jehle PM, Hoeflich A, et al. Insulin-like growth factor-I is an autocrine regulator of chromogranin A secretion and growth in human neuroendocrine tumor cells. Cancer Res. 2000;60(16):4573–81.
Yao JC, Shah MH, Ito T, et al. Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med. 2011;364(6):514–23.
Öberg K, Knigge U, Kwekkeboom D, Perren A, Group EGW. Neuroendocrine gastro-entero-pancreatic tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012;23 Suppl 7:vii 124–30.
Compton C, Byrd D, Garcia-Aguilar J. Exocrine and Endocrine Pancreas. In: Compton C, Byrd D, Garcia-Aguilar J, Kurtzman S, Olawaiye A, Washington M, (eds). AJCC Cancer Staging Atlas. 2nd ed. New York, NY: Springer; 2012:297–308.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Daylami, R., Shah, D., Bold, R.J. (2015). Pancreatic Neuroendocrine Tumors (PNETs). In: Chu, Q., Gibbs, J., Zibari, G. (eds) Surgical Oncology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1423-4_24
Download citation
DOI: https://doi.org/10.1007/978-1-4939-1423-4_24
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-1422-7
Online ISBN: 978-1-4939-1423-4
eBook Packages: MedicineMedicine (R0)