Surgery management for sporadic small (≤2 cm), non-functioning pancreatic neuroendocrine tumors: a consensus statement by the Chinese Study Group for Neuroendocrine Tumors (CSNET)

Yang,Guang; Ji,Meng; Chen,Jie; Chen,Rufu; Chen,Ye; Fu,Deliang; Hou,Baohua; Huang,Heguang; Jiang,Liming; Jin,Kaizhou; Ke,Nengwen; Li,Ying; Li,Yong; Liang,Houjie; Liu,An'an; Luo,Jie; Ni,Quanxing; Shao,Chengwei; Shen,Boyong; Sheng,Weiqi; Song,Bin; Sun,Jian; Tan,Chunlu; Tan,Huangying; Tang,Qiyun; Tang,Yingmei; Tian,Xiaodong; Wang,Jian; Wang,Jie; Wang,Wei; Wang,Wei; Wu,Zheng; Xu,Jin; Yan,Qiang; Yang,Ning; Yang,Yinmo; Yin,Xiaoyu; Yu,Xianjun; Yuan,Chunhui; Zeng,Shan; Zhang,Guochao; Zhang,Renchao; Zhou,Zhiwei; Zhu,Zhaohui; Shao,Chenghao

doi:10.3892/ijo.2016.3826

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Article

Surgery management for sporadic small (≤2 cm), non-functioning pancreatic neuroendocrine tumors: a consensus statement by the Chinese Study Group for Neuroendocrine Tumors (CSNET)

Authors:
- Guang Yang
- Meng Ji
- Jie Chen
- Rufu Chen
- Ye Chen
- Deliang Fu
- Baohua Hou
- Heguang Huang
- Liming Jiang
- Kaizhou Jin
- Nengwen Ke
- Ying Li
- Yong Li
- Houjie Liang
- An'an Liu
- Jie Luo
- Quanxing Ni
- Chengwei Shao
- Boyong Shen
- Weiqi Sheng
- Bin Song
- Jian Sun
- Chunlu Tan
- Huangying Tan
- Qiyun Tang
- Yingmei Tang
- Xiaodong Tian
- Jian Wang
- Jie Wang
- Wei Wang
- Zheng Wu
- Jin Xu
- Qiang Yan
- Ning Yang
- Yinmo Yang
- Xiaoyu Yin
- Xianjun Yu
- Chunhui Yuan
- Shan Zeng
- Guochao Zhang
- Renchao Zhang
- Zhiwei Zhou
- Zhaohui Zhu
- Chenghao Shao
View Affiliations / Copyright

Affiliations: Department of General Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China, Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China, Department of Hepatopancreatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China, Department of Gastroenterology, Nanfang Hospial, Southern Medical University, Guangzhou, Guangdong, P.R. China, Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, P.R. China, Department of General Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R. China, Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, P.R. China, Department of Radiology, Cancer Hospital/Institute, Chinese Academy of Medical Sciences, Beijing, P.R. China, Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University; Pancreatic Cancer Institute, Fudan University, Shanghai, P.R. China, Department of Hepatobiliary and Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China, Department of Radiology, Peking University Cancer Hospital and Institute, Beijing, P.R. China, Department of Oncology, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China, Department of Pathology, China-Japan Friendship Hospital, Beijing, P.R. China, Department of Radiology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, P.R. China, Department of General Surgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China, Department of Pathology, Shanghai Cancer Center, Fudan University, Shanghai, P.R. China, Department of Pancreatic Surgery, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, P.R. China, Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, P.R. China, Department of Gastroenterology, Jiangsu People's Hospital, Nanjing Medical University, Nanjing, Jiangsu, P.R. China, Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Yunnan Research Center for Liver Diseases, Kunming, Yunnan, P.R. China, Department of General Surgery, Peking University First Hospital, Beijing, P.R. China, Department of Biliary and Pancreatic Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China, Department of General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China, Department of General Surgery, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, P.R. China, Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China, Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China, Department of Surgery, Huzhou Central Hospital, Huzhou, Zhejiang, P.R. China, Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, P.R. China, Department of Biliary and Pancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China, Department of General Surgery, Peking University Third Hospital, Peking University, Beijing, P.R. China, Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China, Department of General Surgery, China-Japan Friendship Hospital, Beijing, P.R. China, Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, P.R. China, Department of Nuclear Medicine, Peiking Union Medical College Hospital, Beijing, P.R. China
Pages: 567-574
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Published online on: December 29, 2016

https://doi.org/10.3892/ijo.2016.3826
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Abstract

The incidence of small (≤2 cm), non-functioning pancreatic neuroendocrine tumors (NF-pNETs) increased in the last decades. Before making appropriate strategy for patients with NF-pNETs ≤2 cm, pathological confirmation is vital. Incidentally diagnosed, sporadic small NF-pNETs may bring aggressive behavior and poor prognosis, such as extrapancreatic extension, lymph nodal metastasis, distant metastasis and recurrence, even causing disease-related death. Understanding and formulating an appropriate strategy for the patients with sporadic small, non-functioning pancreatic neuroendocrine tumors have been controversial for some time. Although several studies have reported that patients with NF-pNETs ≤2 cm had less rate of malignant behavior compared with larger ones (>2 cm); and the surgery approach may leading to surgery-related pancreatic complications; but there is still a lack of level I evidence to convince surgeons to abandon all cases with sporadic small NF-pNETs. Based on an updated literature search and review, the members of the Chinese Study Group for Neuroendocrine Tumors (CSNET) from high-volume centers have reached a consensus on the issue of the management strategy for the sporadic small NF-pNETs. We recommend that, except for some selected patients with NF-pNETs <1 cm, incidentally discovered and unacceptable surgical risks, all others with NF-pNETs ≤2 cm should undergo tumor resection with lymph node dissection or at least lymph node sampling and careful postoperative surveillance.

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Medicine International

Surgery management for sporadic small (≤2 cm), non-functioning pancreatic neuroendocrine tumors: a consensus statement by the Chinese Study Group for Neuroendocrine Tumors (CSNET)

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