PMID- 7491542
OWN - NLM
STAT- MEDLINE
DCOM- 19960104
LR  - 20190913
IS  - 0039-6060 (Print)
IS  - 0039-6060 (Linking)
VI  - 118
IP  - 6
DP  - 1995 Dec
TI  - Prospective study of surgical resection of duodenal and pancreatic gastrinomas in 
      multiple endocrine neoplasia type 1.
PG  - 973-9; discussion 979-80
AB  - BACKGROUND: The role of surgical resection of gastrinoma in multiple endocrine 
      neoplasia type 1 (MEN 1) is controversial because of low biochemical cure rates, 
      but with adequate duodenal exploration higher cure rates may be possible. 
      METHODS: We have prospectively evaluated this proposal in ten consecutive 
      patients with MEN 1 and Zollinger-Ellison syndrome who underwent surgical 
      exploration for gastrinoma resection including a detailed evaluation of the 
      duodenum by palpation, intraoperative endoscopy with transillumination, and 
      duodenotomy. RESULTS: Duodenal tumors were present in seven patients. Six of 
      seven patients had metastatic deposits in lymph nodes, and two of seven had 
      synchronous pancreatic tumors. Three patients had a single duodenal tumor, one 
      patient had two tumors, and three patients had more than 20 duodenal tumors. 
      Positive gastrin staining by use of immunohistochemistry was seen in all duodenal 
      tumors. None of these seven patients were biochemically cured. Of three patients 
      with negative duodenal explorations, two had single pancreatic tumors removed and 
      one had only lymph node gastrinoma. No patients were biochemically cured. 
      CONCLUSIONS: Not all patients with MEN 1 and Zollinger-Ellison syndrome have 
      duodenal gastrinomas. In the 70% of patients with duodenal tumors, even extensive 
      duodenal exploration with removal of positive lymph nodes does not result in 
      cures because 86% of tumors had metastasized to lymph nodes and 43% of patients 
      had large numbers of tumors.
FAU - MacFarlane, M P
AU  - MacFarlane MP
AD  - Surgical Metabolism Section, National Cancer Institute, National Institutes of 
      Health, Bethesda, Md 20892, USA.
FAU - Fraker, D L
AU  - Fraker DL
FAU - Alexander, H R
AU  - Alexander HR
FAU - Norton, J A
AU  - Norton JA
FAU - Lubensky, I
AU  - Lubensky I
FAU - Jensen, R T
AU  - Jensen RT
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
RN  - 0 (Gastrins)
SB  - IM
MH  - Adult
MH  - Duodenal Neoplasms/pathology/*surgery
MH  - Female
MH  - Gastrinoma/pathology/*surgery
MH  - Gastrins/analysis
MH  - Humans
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/pathology/*surgery
MH  - Pancreatic Neoplasms/pathology/*surgery
MH  - Prospective Studies
MH  - Zollinger-Ellison Syndrome/surgery
EDAT- 1995/12/01 00:00
MHDA- 1995/12/01 00:01
CRDT- 1995/12/01 00:00
PHST- 1995/12/01 00:00 [pubmed]
PHST- 1995/12/01 00:01 [medline]
PHST- 1995/12/01 00:00 [entrez]
AID - S0039-6060(05)80102-3 [pii]
AID - 10.1016/s0039-6060(05)80102-3 [doi]
PST - ppublish
SO  - Surgery. 1995 Dec;118(6):973-9; discussion 979-80. doi: 
      10.1016/s0039-6060(05)80102-3.