Neuroendocrine tumors of the pancreas: from theory to practical recommendations

Abstract

The article shows that a significant proportion of neuroendocrine tumors of the pancreas are non-functional, i.e., not secreting into the blood a variety of gastrointestinal hormones and polypeptides and as a result, not accompanied by typical clinical manifestations. Unfortunately, often the scan search starts in the detection of distant metastases of neuroendocrine tumors and development of cancer cachexia. Noted that the diagnosis of neuroendocrine tumors of the pancreas is a highly complex task, the solution of which depends on the choice of treatment and its remote results. Currently, the only radical method of treatment of hormonally functioning tumors of the pancreas is surgical. It is indicated that symptomatic therapy can be considered as a stage of preoperative preparation of the patient. The indication for surgical treatment in this situation, along with the ineffectiveness of conservative treatment is the size of detectable formations of 2 cm or more, which is a risk factor of distant metastases. Stressed that according to modern views of patients with nonfunctioning neuroendocrine tumors of the pancreas are subject to surgical treatment. Given that in 70-92% of cases they are malignant, most often used distal or extensive pancreatoduodenal resection. Currently, noted that the large size of the tumors are not a contraindication to surgery and if the tumor dormant, to 1 cm, the possibility of a short observation. Any tumors found in the pancreas, needs to be taken out of the context, or if it is possible – is widely excised. The article examines the rational and integrated use of modern Arsenal of surgical and therapeutic methods, which enable significantly prolong life, improve its quality in patients with metastatic forms of neuroendocrine tumors of the pancreas.