Non-functional neuroendocrine tumors of the pancreas:Advances in diagnosis and management

Nonfunctional neuroendocrine tumors of the pancreas(NF-PNETs) are a heterogeneous group of neoplasms. Although rare, the incidence of NF-PNETs is increasing significantly. The classification of PNETs has evolved over the past decades and is now based on a proliferation grading system. While most NF-...

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Published inWorld journal of gastroenterology : WJG Vol. 21; no. 32; pp. 9512 - 9525
Main Author Cloyd, Jordan M
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 28.08.2015
Subjects
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
carci
Diagnostic Imaging - methods
Disease Progression
Disease-Free Survival
Humans
Liver Neoplasms - secondary
Liver Neoplasms - therapy
Neoplasm Grading
Neoplasm Staging
Neuroendocrine Tumors - diagnosis
Neuroendocrine Tumors - mortality
Neuroendocrine Tumors - secondary
Neuroendocrine Tumors - therapy
Pancreas;Neuroendocrine
Pancreatectomy - adverse effects
Pancreatectomy - mortality
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - mortality
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - therapy
Positron-Emission Tomography
Predictive Value of Tests
Review
Risk Factors
Tomography, X-Ray Computed
Treatment Outcome
tumor;Neuroendocrine
Octreotide
Neuroendocrine tumor
Pancreas
Islet cell
Neuroendocrine carcinoma
Online AccessGet full text
ISSN1007-9327
2219-2840
DOI10.3748/wjg.v21.i32.9512

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Summary:Nonfunctional neuroendocrine tumors of the pancreas(NF-PNETs) are a heterogeneous group of neoplasms. Although rare, the incidence of NF-PNETs is increasing significantly. The classification of PNETs has evolved over the past decades and is now based on a proliferation grading system. While most NF-PNETs are slow growing, tumors with more aggressive biology may becomeincurable once they progress to unresectable metastatic disease. Tumors of higher grade can be suspected preoperatively based on the presence of calcifications, hypoenhancement on arterial phase computed tomography, positron emission technology avidity and lack of octreotide scan uptake. Surgery is the only curative treatment and is recommended for most patients for whom complete resection is possible. Liver-directed therapies(thermal ablation, transarterial embolization) can be useful in controlling unresectable hepatic metastatic disease. In the presence of unresectable progressive disease, somatostatin analogues, everolimus and sunitinib can prolong progression-free survival. This article provides a comprehensive review of NF-PNETs with special emphasis on recent advances in diagnosis and management.
Bibliography:Jordan M Cloyd;George A Poultsides;Department of Surgery,Stanford University, Stanford
Nonfunctional neuroendocrine tumors of the pancreas(NF-PNETs) are a heterogeneous group of neoplasms. Although rare, the incidence of NF-PNETs is increasing significantly. The classification of PNETs has evolved over the past decades and is now based on a proliferation grading system. While most NF-PNETs are slow growing, tumors with more aggressive biology may becomeincurable once they progress to unresectable metastatic disease. Tumors of higher grade can be suspected preoperatively based on the presence of calcifications, hypoenhancement on arterial phase computed tomography, positron emission technology avidity and lack of octreotide scan uptake. Surgery is the only curative treatment and is recommended for most patients for whom complete resection is possible. Liver-directed therapies(thermal ablation, transarterial embolization) can be useful in controlling unresectable hepatic metastatic disease. In the presence of unresectable progressive disease, somatostatin analogues, everolimus and sunitinib can prolong progression-free survival. This article provides a comprehensive review of NF-PNETs with special emphasis on recent advances in diagnosis and management.
Pancreas;Neuroendocrine tumor;Neuroendocrine carci
Author contributions: Cloyd JM and Poultsides GA contributed solely to this manuscript.
Correspondence to: George A Poultsides, MD, Department of Surgery, Stanford University, 300 Pasteur Dr, H3680, Stanford, CA 94305, United States. gpoultsides@stanford.edu
Telephone: +1-650-7234646 Fax: +1-650-8523430
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v21.i32.9512