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Surgery management for sporadic small (≤2 cm), non-functioning pancreatic neuroendocrine tumors: a consensus statement by the Chinese Study Group for Neuroendocrine Tumors (CSNET).

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机构: [1]Department of General Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China. [2]Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China. [3]Department of Hepatopancreatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China. [4]Department of Gastroenterology, Nanfang Hospial, Southern Medical University, Guangzhou, Guangdong, P.R. China. [5]Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, P.R. China. [6]Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R. China. [7]Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, P.R. China. [8]Department of Radiology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences, Beijing, P.R. China. [9]Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center [10]Department of Oncology, Shanghai Medical College, Fudan University [11]Pancreatic Cancer Institute, Fudan University, Shanghai, P.R. China. [10]Department of Hepatobiliary and Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China. [11]Department of Radiology, Peking University Cancer Hospital and Institute, Beijing, P.R. China. [12]Department of Oncology, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China. [13]Department of Pathology, China-Japan Friendship Hospital, Beijing, P.R. China. [14]Department of Radiology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, P.R. China. [15]Department of General Surgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China. [16]Department of Pathology, Shanghai Cancer Center, Fudan University, Shanghai, P.R. China. [17]Department of Pancreatic Surgery, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, P.R. China. [18]Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, P.R. China. [19]Department of Gastroenterology, Jiangsu People's Hospital, Nanjing Medical University, Nanjing, Jiangsu, P.R. China. [20]Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Yunnan Research Center for Liver Diseases, Kunming, Yunnan, P.R. China. [21]Department of General Surgery, Peking University First Hospital, Beijing, P.R. China. [22]Department of Biliary and Pancreatic Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China. [23]Department of General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China. [24]Department of General Surgery, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, P.R. China. [25]Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China. [26]Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China. [27]Department of Surgery, Huzhou Central Hospital, Huzhou, Zhejiang, P.R. China. [28]Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, P.R. China. [29]Department of Biliary and Pancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China. [30]Department of General Surgery, Peking University Third Hospital, Peking University, Beijing, P.R. China. [31]Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China. [32]Department of General Surgery, China-Japan Friendship Hospital, Beijing, P.R. China. [33]Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, P.R. China. [34]Department of Nuclear Medicine, Peiking Union Medical College Hospital, Beijing, P.R. China.
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The incidence of small (≤2 cm), non-functioning pancreatic neuroendocrine tumors (NF-pNETs) increased in the last decades. Before making appropriate strategy for patients with NF-pNETs ≤2 cm, pathological confirmation is vital. Incidentally diagnosed, sporadic small NF-pNETs may bring aggressive behavior and poor prognosis, such as extrapancreatic extension, lymph nodal metastasis, distant metastasis and recurrence, even causing disease-related death. Understanding and formulating an appropriate strategy for the patients with sporadic small, non-functioning pancreatic neuroendocrine tumors have been controversial for some time. Although several studies have reported that patients with NF-pNETs ≤2 cm had less rate of malignant behavior compared with larger ones (>2 cm); and the surgery approach may leading to surgery-related pancreatic complications; but there is still a lack of level I evidence to convince surgeons to abandon all cases with sporadic small NF-pNETs. Based on an updated literature search and review, the members of the Chinese Study Group for Neuroendocrine Tumors (CSNET) from high-volume centers have reached a consensus on the issue of the management strategy for the sporadic small NF-pNETs. We recommend that, except for some selected patients with NF-pNETs <1 cm, incidentally discovered and unacceptable surgical risks, all others with NF-pNETs ≤2 cm should undergo tumor resection with lymph node dissection or at least lymph node sampling and careful postoperative surveillance.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
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Q2 ONCOLOGY
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Q1 ONCOLOGY

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第一作者机构: [1]Department of General Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China.
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通讯机构: [1]Department of General Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China. [*1]Department of General Surgery, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai 200003, P.R. China
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