PMID- 22136834
OWN - NLM
STAT- MEDLINE
DCOM- 20120206
LR  - 20230202
IS  - 1532-7361 (Electronic)
IS  - 0039-6060 (Linking)
VI  - 150
IP  - 6
DP  - 2011 Dec
TI  - Achieving eugastrinemia in MEN1 patients: both duodenal inspection and formal 
      lymph node dissection are important.
PG  - 1143-52
LID - 10.1016/j.surg.2011.09.028 [doi]
AB  - BACKGROUND: Controversy exists regarding the role and extent of operation for 
      patients with multiple endocrine neoplasia type 1 (MEN1) and hypergastrinemia. 
      METHODS: An institutional MEN1 database was reviewed to identify patients with 
      evidence of hypergastrinemia. The relationship of extent of resection to 
      achievement of eugastrinemia was evaluated. RESULTS: Operation was performed in 
      20 patients with MEN1 and hypergastrinemia with a median follow-up of 71 months. 
      Duodenal gastrinomas were identified in 85% of patients who underwent duodenal 
      evaluation. Nodal metastases were identified in 80%. Patients who underwent 
      anatomic regional lymph node dissection (RLND) had a median of 16 nodes removed, 
      vs 1 in patients who did not undergo a formal regional lymphadenectomy. 
      Eugastrinemia was achieved in 12 patients (60%), and 8 (40%) had persistent 
      hypergastrinemia. Compared with patients with persistent hypergastrinemia, 
      patients rendered eugastrinemic more often underwent duodenal evaluation (11/12 
      vs 2/8; P = .01) and RLND (11/12 vs 3/8; P = .03); there was no relationship 
      between pancreatic resection and achievement of eugastrinemia (P = .32). 
      CONCLUSION: For patients with MEN1-associated hypergastrinemia selected for 
      operative treatment, a strategy including duodenal evaluation and anatomic 
      regional lymphadenectomy is associated with long-term eugastrinemia. In contrast, 
      the extent of pancreatic resection should be dictated by the extent and 
      distribution of pancreatic neuroendocrine neoplasms, rather than by the presence 
      of hypergastrinemia.
CI  - Copyright (c) 2011. Published by Mosby, Inc.
FAU - Dickson, Paxton V
AU  - Dickson PV
AD  - Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, 
      Houston, TX 77030-4008, USA.
FAU - Rich, Thereasa A
AU  - Rich TA
FAU - Xing, Yan
AU  - Xing Y
FAU - Cote, Gilbert J
AU  - Cote GJ
FAU - Wang, Huamin
AU  - Wang H
FAU - Perrier, Nancy D
AU  - Perrier ND
FAU - Evans, Douglas B
AU  - Evans DB
FAU - Lee, Jeffrey E
AU  - Lee JE
FAU - Grubbs, Elizabeth G
AU  - Grubbs EG
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
RN  - 0 (Gastrins)
SB  - IM
CIN - Chirurg. 2012 May;83(5):480-1. PMID: 22573248
MH  - Abdomen
MH  - Adult
MH  - Duodenal Neoplasms/blood/diagnosis/*surgery
MH  - Female
MH  - Gastrinoma/blood/*surgery
MH  - Gastrins/*blood
MH  - Humans
MH  - *Lymph Node Excision
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/blood/*surgery
MH  - *Pancreatectomy
MH  - Pancreatic Neoplasms/blood/*surgery
MH  - Pancreaticoduodenectomy
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2011/12/06 06:00
MHDA- 2012/02/07 06:00
CRDT- 2011/12/06 06:00
PHST- 2011/03/02 00:00 [received]
PHST- 2011/09/16 00:00 [accepted]
PHST- 2011/12/06 06:00 [entrez]
PHST- 2011/12/06 06:00 [pubmed]
PHST- 2012/02/07 06:00 [medline]
AID - S0039-6060(11)00542-3 [pii]
AID - 10.1016/j.surg.2011.09.028 [doi]
PST - ppublish
SO  - Surgery. 2011 Dec;150(6):1143-52. doi: 10.1016/j.surg.2011.09.028.