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The Landmark Series: Management of Small Bowel Neuroendocrine Tumors

Catherine G Tran1, Scott K Sherman1, James R Howe2

  • 1Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Annals of Surgical Oncology
|January 16, 2021
PubMed

Insights

Surgical resection is key for small bowel neuroendocrine tumors (SBNETs), improving symptoms and survival. Current guidelines lack robust evidence, highlighting the need for more research on surgical interventions for SBNETs.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Endocrinology

Background:

  • Small bowel neuroendocrine tumors (SBNETs) are primarily managed with surgical resection.
  • Current surgical management guidelines are based on retrospective data.
  • Advanced neuroendocrine tumors (NETs) have shown improved progression-free survival with medical therapies.

Purpose of the Study:

  • To review key studies influencing the surgical management of SBNETs.
  • To identify limitations in the current evidence base for SBNET surgical interventions.

Main Methods:

  • Literature review of studies impacting SBNET management.
  • Analysis of evidence supporting surgical resection and cytoreduction.
  • Examination of data from randomized controlled trials on medical treatments for advanced NETs.

Main Results:

  • Retrospective data suggest primary tumor resection and cytoreduction improve symptoms, prevent complications, and prolong survival in SBNETs.
  • Medical treatments like somatostatin analogues, targeted therapy, and PRRT have demonstrated efficacy in advanced NETs.
  • Significant limitations exist in the evidence supporting specific surgical interventions for SBNETs.

Conclusions:

  • Surgical resection remains foundational for SBNET treatment.
  • Further research is needed to strengthen the evidence base for surgical interventions in SBNET management.
  • Integrating surgical and medical treatment strategies is crucial for advanced SBNETs.

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