Pancreatic Neuroendocrine Tumors: a Modern Approach to Treatment

The aim of the study was to evaluate efficacy of combined treatment for well-differentiated pancreatic neuroendocrine tumors according to the data provided by a specialized center. Materials and Methods. Treatment of 40 patients with pancreatic neuroendocrine tumors was assessed. All of the patients underwent surgical removal of the primary tumor. Liver metastases (stage IV) were diagnosed in 14 patients, postoperative courses of hepatic artery chemoembolization were performed in 12 patients, and 10 of them had well-differentiated cancer. Results. Good survival rates in patients with stage IV disease (n=12) are comparable with those in the group of patients with stage III (n=6) provided tumors are well-differentiated and courses of intra-arterial hepatic chemoembolization are given. In patients with poorly differentiated neuroendocrine tumors (n=7), there was progression within a short time, but survival was less than 1-year after surgery despite active management. Conclusion. To manage well-differentiated pancreatic neuroendocrine tumors, aggressive surgical approach should be used, despite the presence of metastatic lesions. In management of poorly differentiated neuroendocrine cancer, surgical approach proves to have unsatisfactory long-term results.