Francesca Fermi1, Valentina Andreasi1,2, Francesca Muffatti1, Stefano Crippa1,2, Domenico Tamburrino1, Stefano Partelli1,2, Massimo Falconi3,4. 1. Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, OSR ENETS Center of Excellence, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. 2. Vita-Salute San Raffaele University, Milan, Italy. 3. Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, OSR ENETS Center of Excellence, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. falconi.massimo@hsr.it. 4. Vita-Salute San Raffaele University, Milan, Italy. falconi.massimo@hsr.it.
Abstract
PURPOSE OF REVIEW: The aim of this review was to discuss how to select patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) for surgery. RECENT FINDINGS: Surgical resection represents the mainstay for the curative treatment of GEP-NENs. Conservative strategies, such as endoscopic resection and active surveillance, have been recently advocated for the management of patients with small and asymptomatic GEP-NENs. On the other hand, patients with GEP-NENs showing features of aggressiveness should be managed by surgical resection with lymphadenectomy, when the surgical risk is considered acceptable. An accurate selection is important also in the setting of advanced disease, where surgery can provide a survival benefit in the context of a multimodal treatment strategy. Surgical and oncological risk should be always assessed in order to define indications for surgery in patients with GEP-NENs. Given the variety of available treatment options, surgical indication should be always shared with a dedicated multidisciplinary team.
PURPOSE OF REVIEW: The aim of this review was to discuss how to select patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) for surgery. RECENT FINDINGS: Surgical resection represents the mainstay for the curative treatment of GEP-NENs. Conservative strategies, such as endoscopic resection and active surveillance, have been recently advocated for the management of patients with small and asymptomatic GEP-NENs. On the other hand, patients with GEP-NENs showing features of aggressiveness should be managed by surgical resection with lymphadenectomy, when the surgical risk is considered acceptable. An accurate selection is important also in the setting of advanced disease, where surgery can provide a survival benefit in the context of a multimodal treatment strategy. Surgical and oncological risk should be always assessed in order to define indications for surgery in patients with GEP-NENs. Given the variety of available treatment options, surgical indication should be always shared with a dedicated multidisciplinary team.
Authors: C Ricci; S Partelli; L Landoni; M Rinzivillo; C Ingaldi; V Andreasi; C Nessi; F Muffatti; M Fontana; D Tamburrino; G Deiro; L Alberici; D Campana; F Panzuto; C Bassi; M Falconi; R Casadei Journal: Br J Surg Date: 2021-07-23 Impact factor: 6.939
Authors: R Valente; P Lykoudis; D Tamburrino; M Inama; I Passas; C Toumpanakis; T V Luong; B Davidson; C Imber; M Malagò; S H Rahman; A Shankar; D Sharma; M Caplin; G Fusai Journal: Eur J Surg Oncol Date: 2017-08-02 Impact factor: 4.424
Authors: Waddah B Al-Refaie; Helen M Parsons; William G Henderson; Eric H Jensen; Todd M Tuttle; Selwyn M Vickers; David A Rothenberger; Beth A Virnig Journal: Ann Surg Date: 2010-02 Impact factor: 12.969
Authors: Gian Luca Baiocchi; Simone Giacopuzzi; Daniel Reim; Guillaume Piessen; Paulo Matos da Costa; John V Reynolds; Hans-Joachim Meyer; Paolo Morgagni; Ines Gockel; Lucio Lara Santos; Lone Susanne Jensen; Thomas Murphy; Domenico D'Ugo; Riccardo Rosati; Uberto Fumagalli Romario; Maurizio Degiuli; Wojciech Kielan; Stefan Mönig; Piotr Kołodziejczyk; Wojciech Polkowski; Manuel Pera; Paul M Schneider; Bas Wijnhoven; Wobbe O de Steur; Suzanne S Gisbertz; Henk Hartgrink; Johanna W van Sandick; Maristella Botticini; Arnulf H Hölscher; William Allum; Giovanni De Manzoni Journal: Ann Surg Date: 2020-11 Impact factor: 12.969
Authors: Arvind Dasari; Chan Shen; Daniel Halperin; Bo Zhao; Shouhao Zhou; Ying Xu; Tina Shih; James C Yao Journal: JAMA Oncol Date: 2017-10-01 Impact factor: 31.777