Sulciner Megan L, Clancy Thomas E
Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
Cancers (Basel). 2023 Mar 28;15(7):2006. doi: 10.3390/cancers15072006.
Pancreatic neuroendocrine tumors (PNETs) are relatively uncommon malignancies, characterized as either functional or nonfunctional secondary to their secretion of biologically active hormones. A wide range of clinical behavior can be seen, with the primary prognostic indicator being tumor grade as defined by the Ki67 proliferation index and mitotic index. Surgery is the primary treatment modality for PNETs. While functional PNETs should undergo resection for symptom control as well as potential curative intent, nonfunctional PNETs are increasingly managed nonoperatively. There is increasing data to suggest small, nonfunctional PNETs (less than 2 cm) are appropriate follow with nonoperative active surveillance. Evidence supports surgical management of metastatic disease if possible, and occasionally even surgical management of the primary tumor in the setting of widespread metastases. In this review, we highlight the evolving surgical management of local and metastatic PNETs.
胰腺神经内分泌肿瘤（PNETs）是相对罕见的恶性肿瘤，根据其生物活性激素的分泌情况可分为功能性或非功能性。其临床表现多样，主要预后指标是由Ki67增殖指数和有丝分裂指数定义的肿瘤分级。手术是PNETs的主要治疗方式。功能性PNETs应进行切除以控制症状并可能达到治愈目的，而非功能性PNETs越来越多地采用非手术治疗。越来越多的数据表明，小的非功能性PNETs（小于2厘米）适合采用非手术积极监测随访。有证据支持在可能的情况下对转移性疾病进行手术治疗，甚至在广泛转移的情况下偶尔也对原发性肿瘤进行手术治疗。在本综述中，我们重点介绍了局部和转移性PNETs不断发展的手术治疗方法。
