PMID- 30280290
OWN - NLM
STAT- MEDLINE
DCOM- 20190410
LR  - 20190410
IS  - 1573-2606 (Electronic)
IS  - 1389-9155 (Linking)
VI  - 19
IP  - 2
DP  - 2018 Jun
TI  - Curative and palliative surgery in patients with neuroendocrine tumors of the 
      gastro-entero-pancreatic (GEP) tract.
PG  - 169-178
LID - 10.1007/s11154-018-9469-9 [doi]
AB  - The incidence of neuroendocrine tumors (NET) increases with age. Lately, the 
      diagnosis of NET was mainly caused by early detection of small NET (<1 cm) in the 
      rectum and stomach, which are depicted by chance during routine and prophylactic 
      endoscopy. Also in patients with large and metastatic pancreatic and intestinal 
      tumors thorough pathologic investigation with use of different immunohistologic 
      markers discovers more neuroendocrine tumors with low differentiation grade 
      (G2-G3) and more neuroendocrine carcinomas (NEC), nowadays, than in former times. 
      While gastric and rectal NET are discovered as small (<1 cm in diameter) and 
      mainly highly differentiated tumors, demonstrating lymph node metastases in less 
      than 10% of the patients, the majority of pancreatic and small bowel NET have 
      already metastasized at the time of diagnosis. This is of clinical importance, 
      since tumor stage and differentiation grade not only influence prognosis but also 
      surgical procedure and may define whether a combination of surgery with systemic 
      biologic therapy, chemotherapy or local cytoreductive procedures may be used. The 
      indication for surgery and the preferred surgical procedure will have to consider 
      personal risk factors of each patient (i.e. general health, additional illnesses, 
      etc.) and tumor specific factors (i.e. tumor stage, grade of differentiation, 
      functional activity, mass and variety of loco regional as well as distant 
      metastases etc.). Together they define, whether radical curative or only 
      palliative surgery can be applied. Altogether surgery is the only cure for 
      locally advanced NET and helps to increase quality of life and overall survival 
      in many patients with metastatic neuroendocrine tumors. The question of cure 
      versus palliative therapy sometimes only can be answered with time, however. Many 
      different aspects and various questions concerning the indication and extent of 
      surgery and the best therapeutic procedure are still unanswered. Therefore, a 
      close multidisciplinary cooperation of colleagues involved in biochemical and 
      localization diagnostics and those active in various treatment areas is warranted 
      to search for the optimal strategy in each individual patient. How far genetic 
      screening impacts survival remains to be seen. Since surgeons do have a central 
      role in the treatment of NET patients, they have to understand the need for 
      integration into such an interdisciplinary team.
FAU - Goretzki, Peter E
AU  - Goretzki PE
AUID- ORCID: 0000-0001-8997-4896
AD  - Department of Surgery, Campus Charite Mitte | Campus Virchow-Klinikum, 
      Augustenburger Platz 1, 13353, Berlin, Germany. Peter.goretzki@charite.de.
AD  - Leiter Arbeitsbereich endokrine Chirurgie, Chirurgische Klinik, Campus Charite 
      Mitte | Campus Virchow-Klinikum, Charite - Universitatsmedizin Berlin, 
      Augustenburger Platz 1, 13353, Berlin, Germany. Peter.goretzki@charite.de.
FAU - Mogl, Martina T
AU  - Mogl MT
AD  - Department of Surgery, Campus Charite Mitte | Campus Virchow-Klinikum, 
      Augustenburger Platz 1, 13353, Berlin, Germany.
FAU - Akca, Aycan
AU  - Akca A
AD  - Surgical Clinic 1, Lukaskrankenhaus Neuss, Preussenstrasse 84, 41456, Neuss, 
      Germany.
FAU - Pratschke, Johann
AU  - Pratschke J
AD  - Department of Surgery, Campus Charite Mitte | Campus Virchow-Klinikum, 
      Augustenburger Platz 1, 13353, Berlin, Germany.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Germany
TA  - Rev Endocr Metab Disord
JT  - Reviews in endocrine & metabolic disorders
JID - 100940588
RN  - Gastro-enteropancreatic neuroendocrine tumor
SB  - IM
MH  - Humans
MH  - Intestinal Neoplasms/*surgery
MH  - *Neoplasm Metastasis
MH  - Neuroendocrine Tumors/*surgery
MH  - Palliative Care/*methods
MH  - Pancreatic Neoplasms/*surgery
MH  - Stomach Neoplasms/*surgery
OTO - NOTNLM
OT  - Metastases
OT  - Neuroendocrine tumor
OT  - Pancreas
OT  - Small bowel
OT  - Surgery
EDAT- 2018/10/04 06:00
MHDA- 2019/04/11 06:00
CRDT- 2018/10/04 06:00
PHST- 2018/10/04 06:00 [pubmed]
PHST- 2019/04/11 06:00 [medline]
PHST- 2018/10/04 06:00 [entrez]
AID - 10.1007/s11154-018-9469-9 [pii]
AID - 10.1007/s11154-018-9469-9 [doi]
PST - ppublish
SO  - Rev Endocr Metab Disord. 2018 Jun;19(2):169-178. doi: 10.1007/s11154-018-9469-9.