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Non-functioning pancreatic neuroendocrine tumors: Surgery or observation?
Yehonatan Bar-Moshe1, Haggi Mazeh1, Simona Grozinsky-Glasberg1
1Yehonatan Bar-Moshe, Haggi Mazeh, Department of Surgery, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem 91240, Israel.
World Journal of Gastrointestinal Endoscopy
|May 4, 2017
Summary
Small, low-grade, nonfunctional pancreatic neuroendocrine tumors found incidentally may not require surgery. Recent guidelines suggest watchful waiting for these specific pancreatic tumors, challenging traditional resection recommendations.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Endocrinology
Background:
- Increasing diagnosis of incidentally detected, sporadic, nonfunctional pancreatic neuroendocrine tumors (PNETs).
- Controversy exists regarding optimal management due to unpredictable biologic behavior.
- Traditional approach often recommends surgical resection.
Purpose of the Study:
- Review and summarize literature on nonfunctional PNETs.
- Focus on controversies in surgical management.
- Evaluate expectant management strategies.
Main Methods:
- Literature review of studies and guidelines.
- Analysis of nonfunctional PNET management approaches.
- Synthesis of evidence regarding surgical vs. expectant management.
Main Results:
- Emerging evidence supports expectant management for small, low-grade, incidentally diagnosed PNETs.
- Variability in biologic behavior complicates prediction.
- Surgical management remains debated.
Conclusions:
- Expectant management is a viable option for select nonfunctional PNETs.
- Further research needed to refine management guidelines.
- Personalized approach based on tumor characteristics is crucial.
