Pancreatic Surgery UnitUniversità Politecnica delle Marche, Via Conca, 71, 60126 Ancona, ItalyDepartment of SurgeryUniversity of Verona, Verona, Italy.
Pancreatic Surgery UnitUniversità Politecnica delle Marche, Via Conca, 71, 60126 Ancona, ItalyDepartment of SurgeryUniversity of Verona, Verona, Italy
Eur J Endocrinol. 2014 Oct;171(4):R153-62. doi: 10.1530/EJE-14-0173. Epub 2014 Jun 11.
The incidence of neuroendocrine tumors (NETs) has increased in the last decades. Surgical treatment encompasses a panel of approaches ranging from conservative procedures to extended surgical resection. Tumor size and localization usually represent the main drivers in the choice of the most appropriate surgical resection. In the presence of small (<2 cm) and asymptomatic nonfunctioning NETs, a conservative treatment is usually recommended. For localized NETs measuring above 2 cm, surgical resection represents the cornerstone in the management of these tumors. As they are relatively biologically indolent, an extended resection is often justified also in the presence of advanced NETs. Surgical options for NET liver metastases range from limited resection up to liver transplantation. Surgical choices for metastatic NETs need to consider the extent of disease, the grade of tumor, and the presence of extra-abdominal disease. Any surgical procedures should always be balanced with the benefit of survival or relieving symptoms and patients' comorbidities.
在过去几十年中，神经内分泌肿瘤 (NETs) 的发病率有所增加。手术治疗包括一系列方法，从保守手术到广泛的切除术。肿瘤大小和定位通常是选择最合适的手术切除方法的主要驱动因素。对于小的（<2cm）且无症状的无功能 NETs，通常建议采用保守治疗。对于大于 2cm 的局限性 NETs，手术切除是这些肿瘤治疗的基石。由于它们的生物学行为相对惰性，即使存在晚期 NETs，广泛切除也常常是合理的。NET 肝转移的手术选择范围从有限的切除到肝移植。转移性 NET 的手术选择需要考虑疾病的范围、肿瘤的分级和是否存在腹腔外疾病。任何手术程序都应始终与生存或缓解症状和患者合并症的获益相平衡。
