Hori Tomohide, Takaori Kyoichi, Uemoto Shinji
Tomohide Hori, Kyoichi Takaori, Shinji Uemoto, Department of Hepato-Pancreato-Biliary and Transplant Surgery, Kyoto University Hospital, Kyoto 606-8507, Japan.
World J Hepatol. 2014 Aug 27;6(8):596-600. doi: 10.4254/wjh.v6.i8.596.
Pancreatic neuroendocrine tumor (P-NET) is rare and slow-growing. Current classifications predict its prognosis and postoperative recurrence. Curative resection is ideal, although often difficult, because over 80% of patients have unresectable multiple liver metastases and extrahepatic metastasis. Aggressive surgery for liver metastases is important to improve survival. Aggressive or cytoreductive surgery for liver metastases is indicated to reduce hormone levels and improve symptoms and prognosis. Liver transplantation was originally conceived as an ideal therapy for unresectable liver metastases. Unfortunately, there is no clear consensus on the role and timing of surgery for primary tumor and liver metastases. Surgeons still face questions in deciding the best surgical scenario in patients with P-NET with unresectable liver metastases.
胰腺神经内分泌肿瘤（P-NET）罕见且生长缓慢。目前的分类可预测其预后及术后复发情况。根治性切除术是理想的治疗方法，尽管通常难度较大，因为超过80%的患者存在不可切除的多发肝转移和肝外转移。积极的肝转移瘤手术对于提高生存率很重要。对于肝转移瘤进行积极或减瘤手术可降低激素水平，改善症状和预后。肝移植最初被认为是不可切除肝转移瘤的理想治疗方法。不幸的是，对于原发性肿瘤和肝转移瘤手术的作用及时机尚无明确共识。外科医生在为伴有不可切除肝转移的P-NET患者决定最佳手术方案时仍面临诸多问题。
