O'Toole Dermot, Kianmanesh Reza, Farges Olivier, Ruszniewski Philippe
Fédération médico-chirurgicale d'hépato-gastroentérologie Hôpital Beaujon 92118 Clichy.
Rev Prat. 2002 Sep 15;52(14):1546-53.
Control of symptoms due to hormonal secretion is an integral first-step in the management of patients with functional tumours of the pancreatico-duodenal region. Symptomatic drugs should be employed, as well as systemic chemotherapy for nonresectable tumours on the basis of histological differentiation and tumour evolution. Hepatic chemoembolization yields objective response rate of 50%. Surgery however remains the only curative option. Well-differentiated and resectable tumours should be treated by resection, associated with hepatectomy in cases of resectable metastases. Liver transplantation should be reserved for patients with well-differentiated slowly-progressive tumours demonstrating multiple hepatic metastases with a resectable primary in the absence of other metastatic disease. When medical options are inefficacious in the control of hormonal symptoms, cytoreductive surgery can be an effective option.
控制因激素分泌引起的症状是胰腺十二指肠区域功能性肿瘤患者管理中不可或缺的第一步。应使用对症药物，对于不可切除的肿瘤，应根据组织学分化和肿瘤进展情况进行全身化疗。肝动脉化疗栓塞术的客观缓解率为50%。然而，手术仍然是唯一的治愈选择。高分化且可切除的肿瘤应通过切除进行治疗，对于可切除转移灶的病例，可联合肝切除术。肝移植应仅用于高分化、进展缓慢、有多个肝转移灶且原发灶可切除且无其他转移疾病的患者。当药物治疗在控制激素症状方面无效时，减瘤手术可能是一种有效的选择。
