Operationsindikationen bei neuroendokrinen Neoplasien des Pankreas

Translated title of the contribution: Indications for the Surgical Management of Pancreatic Neuroendocrine Neoplasms

Florian Bösch, Orlin Belyaev, Maximilian Brunner, Charlotte Friederieke Müller-Debus, Robert Grützmann, Tobias Keck, Waldemar Uhl, Helmut Witzigmann, Jens Werner*

*Corresponding author for this work

Abstract

Neuroendocrine neoplasms of the pancreas (pNEN) have an increasing incidence and prevalence. Thus, this entity is of increasing clinical significance. Patients with pNEN become clinically apparent due to different and unspecific symptoms. Some tumours secrete hormones and peptides and become clinically symptomatic. In general, these tumours can metastasise early and even small tumours lead to distant metastases. Nonetheless, primary tumour size and grading are important prognostic factors. On the basis of a systematic literature research and the formulation of key issues according to the PICO system, therapeutic concepts were established. These concepts were evaluated with a Delphi process among the members of the pancreas research group and the indications for surgery group of the German Society of General and Visceral Surgery. Thus this article gives an overview of the surgical treatment modalities and indications for the treatment of pNEN. Surgery is still the gold standard in treatment and the only potential chance of cure. Surgery is indicated for sporadic as well as hereditary pNEN > 2 cm independent of the functional activity. A so called wait and see strategy might be indicated in smaller pNEN; however, there is little evidence for this approach. In this respect, pNEN of 1-2 cm represent a surgical indication. The treatment of hereditary pNEN is challenging and should be interdisciplinary. Even in the case of distant metastases, a curative approach might be feasible and multimodal treatment is indicated.

Translated title of the contributionIndications for the Surgical Management of Pancreatic Neuroendocrine Neoplasms
Original languageGerman
JournalZentralblatt fur Chirurgie - Zeitschrift fur Allgemeine, Viszeral- und Gefäßchirurgie
ISSN0044-409X
DOIs
Publication statusPublished - 29.06.2020

Research Areas and Centers

  • Research Area: Luebeck Integrated Oncology Network (LION)

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