Nguyen Scott Q, Angel Luz P, Divino Celia M, Schluender Stefanie, Warner Richard R P
Department of Surgery, Division of General Surgery, The Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
J Surg Oncol. 2007 Oct 1;96(5):397-403. doi: 10.1002/jso.20824.
Because of their rarity and indolent nature, optimal management of malignant pancreatic neuroendocrine tumors remains controversial. The purpose of this study is to review a series of patients with these tumors and investigate the role of surgery in the treatment.
A retrospective study of 73 patients (ages 24-86 years; 36 women) undergoing treatment at a tertiary academic medical center was performed. Patient demographics, diagnostic tests, operations, pathologic findings, adjuvant treatments, and survival were reviewed.
Seventy-four percent of patients had advanced disease with hepatic metastases and 30% had functional tumors. Fifty-seven percent of the patients underwent pancreatic resections. Two 60-day mortalities occurred and the postoperative complication rate was 27%. Overall 5-year survival rate was 44%. There was no difference in survival between patients with functional and nonfunctional tumors. Patients undergoing resection, even in metastatic disease, had better survival than patients who had no resection (60% vs. 30%, P = 0.025). Recurrence occurred in 20% of patients who underwent a curative resection.
Patients with malignant pancreatic neuroendocrine tumors commonly present with advanced disease. Although, curative resection is not frequent, survival benefit may be obtainable with aggressive surgical management even in the face of metastatic disease.
由于恶性胰腺神经内分泌肿瘤罕见且生长缓慢，其最佳治疗方案仍存在争议。本研究旨在回顾一系列此类肿瘤患者，并探讨手术在治疗中的作用。
对在一家三级学术医疗中心接受治疗的73例患者（年龄24 - 86岁；36例女性）进行回顾性研究。回顾了患者的人口统计学资料、诊断检查、手术情况、病理结果、辅助治疗及生存情况。
74%的患者患有伴有肝转移的晚期疾病，30%的患者患有功能性肿瘤。57%的患者接受了胰腺切除术。发生了2例60天内死亡病例，术后并发症发生率为27%。总体5年生存率为44%。功能性肿瘤和非功能性肿瘤患者的生存率无差异。接受手术的患者，即使是转移性疾病患者，其生存率也高于未接受手术的患者（60%对30%，P = 0.025）。接受根治性切除的患者中有20%出现复发。
恶性胰腺神经内分泌肿瘤患者通常表现为晚期疾病。虽然根治性切除并不常见，但即使面对转移性疾病，积极的手术治疗仍可能带来生存获益。
