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Establishment and Characterization of Small Bowel Neuroendocrine Tumor Spheroids
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Outcome of Debulking the Mesenteric Mass in Symptomatic Patients with Locally Advanced Small Intestine Neuroendocrine

Detlef K Bartsch1, Norman Krasser-Gercke1, Anja Rinke2

  • 1Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, 35043 Marburg, Germany.

Cancers
|April 26, 2025
PubMed
Abstract

Insights

Debulking mesenteric masses in locally advanced, symptomatic small intestine neuroendocrine neoplasms (SI-NENs) is a complex surgery. However, this procedure significantly improves bowel symptoms for the majority of patients.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Oncology

Background:

  • Approximately 10% of patients with small intestine neuroendocrine neoplasms (SI-NENs) present with locally advanced, unresectable symptomatic disease.
  • Locally advanced SI-NENs are defined as mesenteric disease involving the mesenteric root above the duodenum or extending into the retroperitoneum.

Purpose of the Study:

  • To analyze the outcomes of debulking mesenteric masses in patients with symptomatic, locally advanced SI-NENs.
  • To evaluate the safety and efficacy of surgical debulking for this patient population.

Main Methods:

  • Retrospective analysis of 29 patients with locally advanced SI-NENs from a prospective database.
  • Inclusion criteria: mesenteric disease involving the mesenteric root above the duodenum and/or extending into the retroperitoneum.
  • Surgical intervention involved debulking of the mesenteric mass, with or without bowel resection.

Main Results:

  • Symptomatic locally advanced disease presented with abdominal pain (76%) and/or obstruction (38%).
  • 28 patients underwent debulking of the mesenteric mass; 93% reported improvement in preoperative abdominal symptoms.
  • Median follow-up was 28 months, with 72% of patients alive with disease; 14% experienced postoperative complications.

Conclusions:

  • Debulking the mesenteric mass in locally advanced symptomatic SI-NENs is a challenging but beneficial procedure.
  • The majority of patients experience significant improvement in bowel symptoms following surgical debulking.
Keywords:
classificationdebulkinglocally advancedsmall intestine neuroendocrine tumorunresectable

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