PMID- 18063064
OWN - NLM
STAT- MEDLINE
DCOM- 20080104
LR  - 20151119
IS  - 1532-7361 (Electronic)
IS  - 0039-6060 (Linking)
VI  - 142
IP  - 6
DP  - 2007 Dec
TI  - Pancreatoduodenal surgery in patients with multiple endocrine neoplasia type 1: 
      Operative outcomes, long-term function, and quality of life.
PG  - 829-36; discussion 836.e1
AB  - BACKGROUND: Pancreatoduodenal (PD) neoplasms represent the principal 
      disease-specific lethality in multiple endocrine neoplasia type 1 (MEN1). 
      Potential oncologic benefits of PD resection must be weighed against operative 
      morbidities, compromised pancreatic function, and quality of life (QOL). METHODS: 
      Fifty MEN1 patients underwent PD resections during 1984-2004. Postoperative 
      pancreatic function and QOL were assessed by EORTC QLQ-C30 and a disease-specific 
      questionnaire (response rate, 78%). RESULTS: Twelve patients (24%) had 
      asymptomatic disease detected by screening; 38 patients (76%) were symptomatic. 
      All gross neoplasm was resected in 80% of patients. No patients died; 21 patients 
      (42%) had complications. At 5 years postoperatively, 60% of patients were alive 
      without disease, 24% of patients were with disease, 10% of patients died of PD 
      neoplasms, 4% of patients died of other malignancies, and 2% of patients died of 
      an unknown cause. Diabetes that requires insulin or oral hypoglycemics developed 
      in 20% of patients. Frequent steatorrhea (>once/week) occurred in 25% of 
      patients, early dumping occurred in 25% of patients, bloating occurred in 25% of 
      patients, late dumping occurred in 7% of patients, hypoglycemia occurred in 7% of 
      patients, and vomiting occurred in 4% of patients. Global QOL did not differ from 
      that of the reference population (72.8 vs 75.3; P = .58). CONCLUSION: PD 
      resections in MEN1 are associated with perioperative risks and altered pancreatic 
      function. The moderate compromise in patient-perceived QOL suggests that most 
      patients accept and adapt to these trade-offs for the potential of prolonged 
      survival.
FAU - You, Y Nancy
AU  - You YN
AD  - Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of 
      Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
FAU - Thompson, Geoffrey B
AU  - Thompson GB
FAU - Young, William F Jr
AU  - Young WF Jr
FAU - Larson, Dirk
AU  - Larson D
FAU - Farley, David R
AU  - Farley DR
FAU - Richards, Melanie
AU  - Richards M
FAU - Grant, Clive S
AU  - Grant CS
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
SB  - IM
EIN - Surgery. 2008 Feb;143(2):302
MH  - Adaptation, Psychological
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Health Surveys
MH  - Humans
MH  - Intraoperative Complications
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/mortality/*psychology/*surgery
MH  - *Pancreaticoduodenectomy
MH  - Postoperative Complications
MH  - *Quality of Life
MH  - Surveys and Questionnaires
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2007/12/08 09:00
MHDA- 2008/01/05 09:00
CRDT- 2007/12/08 09:00
PHST- 2007/03/13 00:00 [received]
PHST- 2007/08/23 00:00 [revised]
PHST- 2007/09/06 00:00 [accepted]
PHST- 2007/12/08 09:00 [pubmed]
PHST- 2008/01/05 09:00 [medline]
PHST- 2007/12/08 09:00 [entrez]
AID - S0039-6060(07)00527-2 [pii]
AID - 10.1016/j.surg.2007.09.010 [doi]
PST - ppublish
SO  - Surgery. 2007 Dec;142(6):829-36; discussion 836.e1. doi: 
      10.1016/j.surg.2007.09.010.