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J.Jpn. Surg. Soc.. 109(3): 143-146, 2008


Feature topic

RECENT ADVANCE IN TREATMENT FOR PANCREATIC NEUROENDOCRINE TUMORS

Professor Emeritus Kyoto University, Director Osaka Saiseikai Noe Hospital, Osaka, Japan

Masayuki Imamura

The recent consensus on the diagnosis and treatment of pancreatic neuroendocrine tumors (PNET) is described. The selective arterial secretagogue injection test and somatostatin receptor scintigraphy are essential for the localization of PNET. A few characteristic clinicopathologic findings of PNET in patients with multiple endocrine neoplasia type 1 (MEN 1) have been elucidated and contributed to improved surgical treatment for these tumors, such as pancreas-preserving total duodenectomy for multiple duodenal gastrinomas in patients with MEN 1 and Zollinger-Ellison syndromes, or distal pancreatectomy for patients with MEN 1 and hypoglycemia. Early diagnosis and early surgical resection of PNET are recommended for complete cure of disease. In liver metastasis of PNET, mass reduction surgery with hepatectomy improves the prognosis of patients, and octreotide LAR has been shown to be useful for reducing complications and inhibiting the growth of tumors.


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