Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Surgery, Stanford University, Stanford, CA, USA.
Ann Surg Oncol. 2021 Feb;28(2):1039-1049. doi: 10.1245/s10434-020-09133-x. Epub 2020 Sep 18.
Pancreatic neuroendocrine tumors (PNETs) comprise a heterogeneous group of neoplasms arising from pancreatic islet cells that remain relatively rare but are increasing in incidence worldwide. While significant advances have been made in recent years with regard to systemic therapies for patients with advanced disease, surgical resection remains the standard of care for most patients with localized tumors. Although formal pancreatectomy with regional lymphadenectomy is the standard approach for most PNETs, pancreas-preserving approaches without formal lymphadenectomy are acceptable for smaller tumors at low risk for lymph node metastases. Furthermore, observation of small, asymptomatic, low-grade PNETs is a safe, initial strategy and is generally recommended for tumors < 1 cm in size. In this Landmark Series review, we highlight the critical studies that have defined the surgical management of PNETs.
胰腺神经内分泌肿瘤（PNETs）是一组起源于胰岛细胞的异质性肿瘤，相对较少见，但在全球范围内发病率正在增加。虽然近年来在晚期患者的系统治疗方面取得了重大进展，但手术切除仍然是大多数局限性肿瘤患者的标准治疗方法。虽然大多数 PNET 采用标准的胰十二指肠切除术和区域淋巴结清扫术，但对于淋巴结转移风险较低的较小肿瘤，可以采用不进行正式淋巴结清扫的保留胰腺的方法。此外，观察体积小、无症状、低度恶性的 PNET 是一种安全的初始策略，一般推荐用于直径小于 1cm 的肿瘤。在本系列标志性研究综述中，我们重点介绍了明确 PNET 手术治疗的关键研究。
