Role of surgical treatments in high-grade or advanced gastroenteropancreatic neuroendocrine neoplasms  

作　　者：Qing-Yang Que Lin-Cheng Zhang Jia-Qi Bao Sun-Bin Ling Xiao Xu 

机构地区：[1]Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province,Hangzhou 310006,Zhejiang Province,China [2]Zhejiang University Cancer Center,Hangzhou 310006,Zhejiang Province,China [3]NHC Key Laboratory of Combined Multi-organ Transplantation,Hangzhou 310006,Zhejiang Province,China [4]Department of Hepatobiliary and Pancreatic Surgery,Affiliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,Zhejiang Province,China [5]Institute of Organ Transplantation,Zhejiang University,Hangzhou 310003,Zhejiang Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2022年第5期397-408,共12页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by State Key Program of National Natural Science Foundation of China,No.81930016;Zhejiang Provincial Natural Science Foundation of China,No.LY21H160026。

摘　　要：Over the last 40 years,the incidence and prevalence of gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)have continued to increase.Compared to other epithelial neoplasms in the same organ,GEP-NENs exhibit indolent biological behavior,resulting in more chances to undergo surgery.However,the role of surgery in high-grade or advanced GEP-NENs is still controversial.Surgery is associated with survival improvement of well-differentiated highgrade GEP-NENs,whereas poorly differentiated GEP-NENs that may benefit from resection require careful selection based on Ki67 and other tissue biomarkers.Additionally,surgery also plays an important role in locally advanced and metastatic disease.For locally advanced GEP-NENs,isolated major vascular involvement is no longer an absolute contraindication.In the setting of metastatic GEP-NENs,radical intended surgery is recommended for patients with low-grade and resectable metastases.For unresectable metastatic disease,a variety of surgical approaches,including cytoreduction of liver metastasis,liver transplantation,and surgery after neoadjuvant treatment,show survival benefits.Primary tumor resection in GEP-NENs with unresectable metastatic disease is associated with symptom control,prolonged survival,and improved sensitivity toward systemic therapies.Although there is no established neoadjuvant or adjuvant strategy,increasing attention has been given to this emerging research area.Some studies have reported that neoadjuvant therapy effectively reduces tumor burden,improves the effectiveness of subsequent surgery,and decreases surgical complications.

关 键 词：Gastroenteropancreatic neuroendocrine neoplasms Neuroendocrine carcinomas SURGERY Hepatic debulking Liver transplant Transplant oncology 

分 类 号：R735[医药卫生—肿瘤]