title: Management of the primary tumor in patients with metastatic pancreatic neuroendocrine tumor: a contemporary single-institution review.
abstract: BACKGROUND
  Pancreatic nonfunctioning neuroendocrine tumors (PNFNETs) are an uncommon malignancy and often present with metastatic disease. There is a lack of information on the management of the primary tumor in patients who present with unresectable synchronous hepatic metastases.
  
  
  METHODS
  A retrospective review (2001-2008) of PNFNETs was conducted. Patients were divided into 3 groups: PNFNET without evidence of hepatic metastasis (group A), PNFNET with metastatic disease involving less than 50% of the liver (group B), and PNFNET with metastatic disease involving more than 50% of the liver (group C). Clinical data and outcomes were analyzed.
  
  
  RESULTS
  Thirty-five patients with PNFNET were identified (group A = 15, group B = 11, group C = 9). Resection of the pancreatic tumor was performed in 26 patients. With a mean follow-up period of 30 months, death from disease progression occurred in 1 patient in group A, none in group B, and in 7 in group C.
  
  
  CONCLUSIONS
  In selected patients, resection of the primary pancreatic tumor even in the setting of unresectable but limited hepatic metastases may be indicated.
authors.affiliation: Eppley Cancer Center, Department of Surgery, Division of Surgical Oncology, Omaha, NE 68198-4030, USA.
authors.forename: Matias
authors.initials: M
authors.lastname: Bruzoni
authors.forename: Purvi
authors.initials: P
authors.lastname: Parikh
authors.forename: Rolando
authors.initials: R
authors.lastname: Celis
authors.forename: Chandrakanth
authors.initials: C
authors.lastname: Are
authors.forename: Quan P
authors.initials: QP
authors.lastname: Ly
authors.forename: Jane L
authors.initials: JL
authors.lastname: Meza
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Sasson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D018358:Neuroendocrine Tumors / Q000556:secondary / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies