title: Surgical treatment of sporadic pancreatic neuroendocrine tumors: a state of the art review.
abstract: Pancreatic neuroendocrine tumors (PNETs) are rare neoplasms. They are clinically diverse and divided into functioning and nonfunctioning disease, depending on their ability to produce symptoms due to hormone production. Surgical resection is the only curative treatment and remains the cornerstone therapy for this patient group, even in patients with advanced disease. Over the last decade there has been a noticeable trend towards more aggressive surgery as well as more minimally invasive surgery in patients with PNETs. This has resulted in improved long-term survival in patients with locally advanced and metastatic disease treated aggressively, as well as shorter hospital stays and comparable long-term outcomes in patients with limited disease treated minimally invasively. There are still controversies related to issues of surgical treatment of PNETs, such as to what extent enucleation, lymph node sampling, and vascular reconstruction are beneficial for the oncologic outcome. Histopathologic tumor classification is of high clinical importance for treatment planning and prognostic evaluation of patients with PNETs. A constant challenge, which relates to the treatment of PNETs, is the lack of an internationally accepted histopathological classification system. This paper reviews current issues on the surgical treatment of sporadic PNETs with specific focus on surgical approaches and tumor classification.
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway. svhaug@ous-hf.no
authors.forename: Sven-Petter
authors.initials: SP
authors.lastname: Haugvik
authors.forename: Knut Jørgen
authors.initials: KJ
authors.lastname: Labori
authors.forename: Bjørn
authors.initials: B
authors.lastname: Edwin
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Mathisen
authors.forename: Ivar Prydz
authors.initials: IP
authors.lastname: Gladhaug
mesh_terms: D000818:Animals; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods* / Q000592:standards / Q000639:trends*; D018358:Neuroendocrine Tumors / Q000473:pathology* / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*