邮件订阅 RSS

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

胰腺神经内分泌肿瘤肝转移的外科治疗

邵成浩,  彭俊峰

downloadPDF
文章导航 > 协和医学杂志  > 2020 >  11(4): 383-388
邵成浩, 彭俊峰. 胰腺神经内分泌肿瘤肝转移的外科治疗[J]. 协和医学杂志, 2020, 11(4): 383-388. doi: 10.3969/j.issn.1674-9081.2020.04.005
引用本文: 邵成浩, 彭俊峰. 胰腺神经内分泌肿瘤肝转移的外科治疗[J]. 协和医学杂志, 2020, 11(4): 383-388. doi: 10.3969/j.issn.1674-9081.2020.04.005
shu
Cheng-hao SHAO, Jun-feng PENG. Surgical Treatment of Pancreatic Neuroendocrine Neoplasm with Liver Metastasis[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(4): 383-388. doi: 10.3969/j.issn.1674-9081.2020.04.005
Citation: Cheng-hao SHAO, Jun-feng PENG. Surgical Treatment of Pancreatic Neuroendocrine Neoplasm with Liver Metastasis[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(4): 383-388. doi: 10.3969/j.issn.1674-9081.2020.04.005
shu

胰腺神经内分泌肿瘤肝转移的外科治疗

doi: 10.3969/j.issn.1674-9081.2020.04.005

  • 海军军医大学附属长征医院普通外科/胰胆外科, 上海 200003

基金项目: 

上海市卫生计生系统优秀学科带头人(新百人计划)项目 2017BR040

详细信息
    通讯作者:

    邵成浩  电话:021-81885613, E-mail:shaochenghao@smmu.edu.cn

  • 中图分类号: R735.9;R58;R61

Surgical Treatment of Pancreatic Neuroendocrine Neoplasm with Liver Metastasis

  • Department of General Surgery and Pancreaticobiliary Surgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China

More Information

    摘要
  • 摘要: 胰腺神经内分泌肿瘤(pancreatic neuroendocrine neoplasm, pNEN)是一类比较少见的胰腺肿瘤, 其发病率近年来呈上升趋势。pNEN肝转移的治疗需综合考虑其病理分级、肿瘤分期、肝转移负荷及肝外转移情况, 在全面评估的基础上, 开展多学科协作, 制定最佳诊疗方案, 以控制肿瘤生长、减小肿瘤负荷、控制激素过多分泌及相关并发症、延长患者生存期为主要目标。手术是治疗pNEN肝转移的有效手段, 有助于改善pNEN肝转移患者的预后。本文结合文献综述和笔者的临床诊疗经验, 阐述目前pNEN肝转移手术治疗需关注的问题, 以为临床提供指导。
    Abstract: Pancreatic neuroendocrine neoplasm (pNEN) is a relatively rare type of pancreatic tumor, and its incidence has been on the rise in recent years. The treatment of pNEN with liver metastasis needs comprehensive consideration of its pathological grade, tumor stage, liver metastasis burden, and extrahepatic metastasis, etc. On the basis of comprehensive evaluation, multidisciplinary team is needed to formulate the best diagnosis and treatment plan, and the main goals are to control tumor growth, reduce tumor burden, control excessive hormone secretion and related complications, and prolong patient survival. Surgery is an effective treatment method for pNEN with liver metastasis, which helps to improve the prognosis of patients. Based on literature review and our experiences, this article elaborated the current major issues of concern, to provide a guide for surgical treatment of pNEN with liver metastasis.
    利益冲突  无
    • HTML全文
    • 参考文献(37)
  • [1] WHO Classification of Tumours Editorial Board. WHO Classification of Tumours. Digestive System Tumours[M]. 5th ed. Lyon:International Agency for Research on Cancer, 2019:343-372.
    [2] Amin MB, Edge S, Greene F, et al. AJCC Cancer Staging Manual[M]. 8th ed. New York:Springer, 2017:407-419.
    [3] Zhai H, Li D, Feng Q, et al. Pancreatic Neuroendocrine Tumours:Grade is superior to T, N, or M status in pre-dicting outcome and selecting patients for chemotherapy:A retrospective cohort study in the SEER database[J]. Int J Surg, 2019, 66:103-109. doi:  10.1016/j.ijsu.2019.03.006
    [4] Rindi G, Klersy C, Albarello L, et al. Competitive Testing of the WHO 2010 versus the WHO 2017 Grading of Pancreatic Neuroendocrine Neoplasms:Data from a Large International Cohort Study[J]. Neuroendocrinology, 2018, 107:375-386. doi:  10.1159/000494355
    [5] Rindi G, Falconi M, Klersy C, et al. TNM staging of neoplasms of the endocrine pancreas:Results from a large international cohort study[J]. J Natl Cancer Inst, 2012, 104:764-777. doi:  10.1093/jnci/djs208
    [6] Scott AT, Howe JR. Evaluation and Management of Neuroendocrine Tumors of the Pancreas[J]. Surg Clin North Am, 2019, 99:793-814. doi:  10.1016/j.suc.2019.04.014
    [7] Wen J, Chen J, Liu D, et al. The Eighth Edition of the American Joint Committee on Cancer Distant Metastases Stage Classification for Metastatic Pancreatic Neuroendocrine Tumors Might Be Feasible for Metastatic Pancreatic Ductal Adenocarcinomas[J]. Neuroendocrinology, 2020, 110:364-376. doi:  10.1159/000502382
    [8] Zhang X, Song J, Liu P, et al. A modified M-stage classification based on the metastatic patterns of pancreatic neuroendocrine neoplasms:a population-based study[J]. BMC Endocr Disord, 2018, 18:73. doi:  10.1186/s12902-018-0301-z
    [9] Sorbye H, Baudin E, Perren A. The Problem of High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms:Well-Differentiated Neuroendocrine Tumors, Neuroendocrine Carcinomas, and Beyond[J]. Endocrinol Metab Clin North Am, 2018, 47:683-698. doi:  10.1016/j.ecl.2018.05.001
    [10] Yoshida T, Hijioka S, Hosoda W, et al. Surgery for Pancreatic Neuroendocrine Tumor G3 and Carcinoma G3 Should be Considered Separately[J]. Ann Surg Oncol, 2019, 26:1385-1393. doi:  10.1245/s10434-019-07252-8
    [11] Worth PJ, Leal J, Ding Q, et al. Pancreatic grade 3 neuroendocrine tumors behave similarly to neuroendocrine carcinomas following resection:a multi-center, international app-raisal of the WHO 2010 and WHO 2017 staging schema for pancreatic neuroendocrine lesions[J].HPB (Oxford), 2020:S1365-182X(20)30001-0.
    [12] Chan DL, Bernard E, Schembri G, et al. High metabolic tumour volume on FDG PET predicts poor survival from neuroendocrine neoplasms[J]. Neuroendocrinology, 2019:10.1159/000504673.
    [13] Carideo L, Prosperi D, Panzuto F, et al. Role of Combined[68Ga]Ga-DOTA-SST Analogues and[18F]FDG PET/CT in the Management of GEP-NENs:A Systematic Review[J]. J Clin Med, 2019, 8:1032 doi:  10.3390/jcm8071032
    [14] Scott AT, Weitz M, Breheny PJ, et al. Gene Expression Signatures Identify Novel Therapeutics for Metastatic Pancreatic Neuroendocrine Tumors[J]. Clin Cancer Res, 2020, 26:2011-2021. doi:  10.1158/1078-0432.CCR-19-2884
    [15] Deguelte S, de Mestier L, Hentic O, et al. Preoperative imaging and pathologic classification for pancreatic neuroendocrine tumors[J].J Visc Surg, 2018, 155:117-125. doi:  10.1016/j.jviscsurg.2017.12.008
    [16] Van Beers BE, Pastor CM, Hussain HK. Primovist, Eovist:what to expect?[J]. J Hepatol, 2012, 57:421-429. doi:  10.1016/j.jhep.2012.01.031
    [17] Sourbron S, Sommer WH, Reiser MF, et al. Combined quantification of liver perfusion and function with dynamic gadoxetic acid-enhanced MR imaging[J]. Radiology, 2012, 263:874-883. doi:  10.1148/radiol.12110337
    [18] Howe JR, Merchant NB, Conrad C, et al. The North American Neuroendocrine Tumor Society Consensus Paper on the Surgical Management of Pancreatic Neuroendocrine Tumors[J]. Pancreas, 2020, 49:1-33. doi:  10.1097/MPA.0000000000001454
    [19] Elias D, Lefevre JH, Duvillard P, et al. Hepatic metastases from neuroendocrine tumors with a "thin slice" pathological examination:they are many more than you think[J]. Ann Surg, 2010, 251:307-310. doi:  10.1097/SLA.0b013e3181bdf8cf
    [20] Rozenblum L, Mokrane FZ, Yeh R, et al. Imaging-guided precision medicine in non-resectable gastro-entero-pancreatic neuroendocrine tumors:A step-by-step approach[J]. Eur J Radiol, 2020, 122:108743. doi:  10.1016/j.ejrad.2019.108743
    [21] Pettersson O, Fröss-Baron K, Crona J, et al. Tumor Contrast-Enhancement for Monitoring of PRRT 177Lu-DOTATATE in Pancreatic Neuroendocrine Tumor Patients[J]. Front Oncol, 2020, 10:193. doi:  10.3389/fonc.2020.00193
    [22] de Graaf W, van Lienden KP, Dinant S, et al. Assessment of future remnant liver function using hepatobiliary scintigraphy in patients undergoing major liver resection[J].J Gastrointest Surg, 2010, 14:369-378. doi:  10.1007/s11605-009-1085-2
    [23] Kubota K, Makuuchi M, Kusaka K, et al. Measurement of liver volume and hepatic functional reserve as a guide to decision-making in resectional surgery for hepatic tumors[J]. Hepatology, 1997, 26:1176-1181.
    [24] 彭俊峰, 邵成浩.侵犯大血管的胰腺神经内分泌肿瘤外科治疗[J].中国实用外科杂志, 2019, 39:914-916. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgsywkzz201909008
    [25] Jin K, Xu J, Chen J, et al. Surgical management for non-functional pancreatic neuroendocrine neoplasms with synchronous liver metastasis:A consensus from the Chinese Study Group for Neuroendocrine Tumors (CSNET)[J]. Int J Oncol, 2016, 49:1991-2000. doi:  10.3892/ijo.2016.3711
    [26] Wang S, Zhang J, Liu S, et al. The prognostic analysis of different metastatic patterns in pancreatic neuroendocrine tumors patients:A population based analysis[J]. Medicine (Baltimore), 2019, 98:e17773. doi:  10.1097/MD.0000000000017773
    [27] Pavel M, Baudin E, Couvelard A, et al. ENETS Consensus Guidelines for the Management of Patients with Liver and Other Distant Metastases from Neuroendocrine Neoplasms of Foregut, Midgut, Hindgut, and Unknown Primary[J]. Neuroendocrinology, 2012, 95:157-176. doi:  10.1159/000335597
    [28] Touzios JG, Kiely JM, Pitt SC, et al. Neuroendocrine hepa-tic metastases:Does aggressive management improve survival?[J]. Ann Surg, 2005, 241:776-785. doi:  10.1097/01.sla.0000161981.58631.ab
    [29] Nigri G, Petrucciani N, Debs T, et al. Treatment options for PNET liver metastases:A systematic review[J]. World J Surg Oncol, 2018, 16:142. doi:  10.1186/s12957-018-1446-y
    [30] Spolverato G, Bagante F, Aldrighetti L, et al. Management and outcomes of patients with recurrent neuroendocrine liver metastasis after curative surgery:An international multi-institutional analysis[J]. J Surg Oncol, 2017, 116:298-306. doi:  10.1002/jso.24670
    [31] Morgan RE, Pommier SJ, Pommier RF. Expanded criteria for debulking of liver metastasis also apply to pancreatic neuroendocrine tumors[J].Surgery, 2018, 163:218-225. doi:  10.1016/j.surg.2017.05.030
    [32] Scott AT, Breheny PJ, Keck KJ, et al. Effective cytoreduction can be achieved in patients with numerous neuroendocr-ine tumor liver metastases (NETLMs)[J]. Surgery, 2019, 165:166-175. doi:  10.1016/j.surg.2018.04.070
    [33] Lesurtel M, Nagorney DM, Mazzaferro V, et al. When should a liver resection be performed in patients with liver metastases from neuroendocrine tumours? A systematic review with practice recommendations[J]. HPB (Oxford), 2015, 17:17-22. doi:  10.1111/hpb.12225
    [34] Rinke A, Wittenberg M, Schade-Brittinger C, et al. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide lar in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors (PROMID):Results of long-term survival[J]. Neuroendocrinology, 2017, 104:26-32. doi:  10.1159/000443612
    [35] Lim C, Lahat E, Osseis M, et al. Liver Transplantation for Neuroendocrine Tumors:What Have We Learned?[J]. Semin Liver Dis, 2018, 38:351-356. doi:  10.1055/s-0038-1669936
    [36] Ruzzenente A, Bagante F, Bertuzzo F, et al. Liver Resec-tion for Neuroendocrine Tumor Liver Metastases Within Milan Criteria for Liver Transplantation[J]. J Gastrointest Surg, 2019, 23:93-100. doi:  10.1007/s11605-018-3973-9
    [37] Sposito C, Droz Dit Busset M, Citterio D, et al. The place of liver transplantation in the treatment of hepatic metastases from neuroendocrine tumors:Pros and cons[J]. Rev Endocr Metab Disord, 2017, 18:473-483. doi:  10.1007/s11154-017-9439-7
    • 相关文章
    • 施引文献
  • 资源附件(0)
  • 加载中
WeChat 点击查看大图
计量
  • 文章访问数:  172
  • HTML全文浏览量:  39
  • PDF下载量:  21
  • 被引次数: 0
出版历程
  • 收稿日期:  2020-04-03
  • 刊出日期:  2020-07-30

目录

    /

    返回文章
    返回
    友情链接: 国家卫生健康委员会 北京协和医院 中国医学科学院 学术不端检测系统 国际知识资源总库 中国知网 术语在线 中国全科医学
    地址：北京市东城区帅府园1号 北京协和医院老楼7号楼
    3层302室 《协和医学杂志》编辑部
    电话：010-69154261/4262
    E - mail：medj@pumch.cn
    mjpumch@126.com
    期刊网站版权所有：《协和医学杂志》编辑部
    京ICP备 11002662

    本系统由 北京仁和汇智信息技术有限公司 开发    百度统计

    x 关闭 永久关闭

    【温馨提醒】近日，《协和医学杂志》编辑部接到作者反映，有多名不法人员冒充期刊编辑发送见刊通知，鼓动作者添加微信，从而骗取版面费的行为。特提醒您，本刊与作者联系的方式均为邮件通知或电话，稿件进度通知邮箱为：mjpumch@126.com，编辑部电话为：010-69154261，请提高警惕，谨防上当受骗！如有任何疑问，请致电编辑部核实。谢谢！