Surgical Indications and Outcomes of Resection for Pancreatic Neuroendocrine Tumors with Vascular Involvement

Cancers

Monica M. Dua¹  Amy Y. Li¹  Brendan C. Visser¹ 

[1] Division of Surgical Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA;

关键词: pancreatic neuroendocrine tumors;    vascular involvement;    vascular reconstruction;    mesocaval shunt;   

DOI  :  10.3390/cancers14092312

来源: DOAJ

【 摘 要 】

Complete surgical resection of pancreatic neuroendocrine tumors (pNETs) has been suggested as the only potentially curative treatment. A proportion of these tumors will present late during disease progression, and invade or encase surrounding vasculature; therefore, surgical treatment of locally advanced disease remains controversial. The role of surgery with vascular reconstruction in pNETs is not well defined, and there is considerable variability in the use of aggressive surgery for these tumors. Accurate preoperative assessment is critical to evaluate individual considerations, such as anatomical variants, areas and lengths of vessel involvement, proximal and distal targets, and collateralization secondary to the degree of occlusion. Surgical approaches to address pNETs with venous involvement may include thrombectomy, traditional vein reconstruction, a reconstruction-first approach, or mesocaval shunting. Although the amount of literature on pNETs with vascular reconstruction is limited to case reports and small institutional series, the last two decades of studies have demonstrated that aggressive resection of these tumors can be performed safely and with acceptable long-term survival.

【 授权许可】

Unknown