Surgery on neuroendocrine tumours.

Area of Science:

• Gastroenterology
• Endocrinology
• Surgical Oncology

Background:

• Neuroendocrine tumors (NETs) of the gastrointestinal tract and pancreas pose diagnostic and therapeutic challenges.
• Surgical intervention is increasingly vital for symptom palliation and improving survival in NET patients.

Purpose of the Study:

• To highlight the importance and specific surgical considerations for various types of gastrointestinal and pancreatic NETs.
• To underscore the role of surgery in managing carcinoid syndrome and hormone-secreting pancreatic tumors.

Main Methods:

• Review of surgical approaches for different NETs.
• Emphasis on pre- and intraoperative localization techniques for endocrine pancreatic tumors.

Main Results:

• Surgery is essential for primary and mesenteric carcinoid tumors to prevent complications and manage carcinoid syndrome.
• Liver metastases from midgut carcinoids require resection for symptom palliation.
• Insulinomas and gastrinomas, despite small size, can be localized and surgically removed.
• Debulking surgery for larger or metastatic glucagonomas, VIPomas, and non-functioning NETs alleviates hormonal symptoms and improves survival.

Conclusions:

• Surgical management is a cornerstone in treating NETs, offering significant benefits for palliation and survival.
• Tailored surgical strategies based on tumor type, size, and location are critical for optimal patient outcomes.