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Pankreas Nöroendokrin Tümörlerinin Cerrahi Tedavisinde 11 Yıllık Tek Merkez Deneyimi

Yıl 2022, Cilt 19, Sayı 2, 309 - 312, 28.08.2022
https://doi.org/10.35440/hutfd.1126786

Öz

Giriş: Pankreatik nöroendokrin tümörler (pNET) nadir görülen hastalıklardır ve cerrahi ön planlı tedavi yüz güldürücüdür. Bu çalışmada hastanemizde son 11 yılda pankreatik nöroendokrin tümör nedeniyle cerrahi tedavi uygulanmış hastaları geriye dönük inceleyerek; bulgularımızı literatüre sunmayı amaçladık. Materyal Metod: Ocak 2011 ile Mart 2022 tarihleri arasında pNET nedeniyle başvuran hastaların dosyaları geriye dönük incelendi. Çoklu veri eksiği olan, operasyon yapılmamış ve 18 yaşından küçük olan hastalar çalışma dışı bırakıldı. Hastalar yaş, cinsiyet, operasyon türü, tümör boyutu, tipi ve histolojik özellikleri, hastanede kalış, nüks hastalık ve sağ kalım açısından değerlendirildi. Bulgular: Çalışmaya alınan 33 hastanın 13’ü kadın 20’si erkektı ve yaş ortanca değeri 56 (18-86) idi. Fonksiyonel tümörü olan 8 hasta vardı ve biri somatostatinoma olup diğerleri insülinomaydı. Hastaların 7’sine enükleasyon; 26’sına pankreatektomi yapıldı. Ana lezyonu adenokanser ve seröz kistadenom olup rezeksiyon uygulanan ve spesmen patolojisinde insidental pNET saptanan üç hasta vardı. Tümörü grade 1, 2 ve 3 olan sırasıyla 23, 7 ve 3 hastamız vardı. Tümör çapı ortanca değeri 24 (3-80) mm idi. Hastanede yatış süresi ortanca değeri 7 (2-50) gündü. Takip süresi ortanca değeri 24 (1-71) ay; hastalıksız sağ kalım 14 (1-71) aydı. Tartışma ve Sonuç: pNET’ler nadir görülen ve insidental olarak da saptanabilen, titizlikle yönetilmesi gereken hastalıklardır. pNET’in cerrahi ve konservatif tedavisinde fikir birliği sağlanabilmesi için daha geniş serileri içeren çalışmalar yapılması gerekmektedir.

Kaynakça

  • 1. Maralcan G. Pancreatic Neuroendocrin Tumors.Turkiye Klinikleri J Gen Surg-Special Topics. 2016;9(3):87-90.
  • 2. Mpilla GB, Philip PA, El-Rayes B, Azmi AS. Pancreatic neuroendocrine tumors: Therapeutic challenges and research limitations. World J Gastroenterol. 2020;26(28):4036-4054.
  • 3. Grozinsky-Glasberg S, Mazeh H, Gross DJ. Clinical features of pancreatic neuroendocrine tumors. J Hepatobiliary Pancreat Sci. 2015 Aug;22(8):578-585.
  • 4. Metz DC, Jensen RT. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology 2008;135:1469-1492.
  • 5. Parbhu, S. K., & Adler, D. G. . Pancreatic neuroendocrine tumors: contemporary diagnosis and management. Hospital practice, 2016;44(3),109-119.
  • 6. Giannis D, Moris D, Karachaliou GS, Tsilimigras DI, Karaolanis G, Papalampros A, Felekouras E. Insulinomas: from diagnosis to treatment. A review of the literature. J BUON. 2020;25(3):1302-1314.
  • 7. Serin, K. R, Büyük, M, Güllüoğlu. M, İbiş C, Tekan Y , Özden İ. “Pankreas nöroendokrin tümörlerinin cerrahi tedavisinin uzun dönem sonuçları” . Hitit Medical Journal 2 2020:20-21.
  • 8. Partelli S, Giannone F, Schiavo Lena M, Muffatti F, Andreasi V, et. al. Is the Real Prevalence of Pancreatic Neuroendocrine Tumors Underestimated? A Retrospective Study on a Large Series of Pancreatic Specimens. Neuroendocrinology. 2019;109:165-170.
  • 9. Beane JD, Borrebach JD, Billderback A, Onuma AE, Adam MA, Zureikat AH, Pitt HA. Small pancreatic neuroendocrine tumors: Resect or enucleate? Am J Surg. 2021;222(1):29-34.
  • 10. Jilesen AP, van Eijck CH, Busch OR, van Gulik TM, Gouma DJ, van Dijkum EJ. Postoperative Outcomes of Enucleation and Standard Resections in Patients with a Pancreatic Neuroendocrine Tumor. World J Surg. 2016;40(3):715-728.
  • 11. Klöppel G, Couvelard A, Perren A, Komminoth P, McNicol AM, Nilsson O, et. al. Mallorca Consensus Conference participants; European Neuroendocrine Tumor Society. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: towards a standardized approach to the diagnosis of gastroenteropancreatic neuroendocrine tumors and their prognostic stratification. Neuroenodocrinology. 2009;90:162-166
  • 12. Pavel M, Öberg K, Falconi M, Krenning EP, Sundin A, Perren A, Berruti A; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(7):844-860.
  • 13. Lo GC, Kambadakone A. MR Imaging of Pancreatic Neuroendocrine Tumors. Magn Reson Imaging Clin N Am. 2018;26(3):391-403.

11-Year Single Center Experience in The Surgical Treatment of Pancreatic Neuroendocrine Tumors

Yıl 2022, Cilt 19, Sayı 2, 309 - 312, 28.08.2022
https://doi.org/10.35440/hutfd.1126786

Öz

Background: Pancreatic neuroendocrine tumors (pNET) are rare diseases and surgical treatment is promi-sing. In this study, we retrospectively analyzed the patients who underwent surgical treatment for pancrea-tic neuroendocrine tumor in our hospital in the last 11 years; We aimed to present our findings to the litera-ture.
Materials and Methods: The files of the patients who applied for pNET between January 2011 and March 2022 were retrospectively analyzed. Patients with multiple data deficiencies, who did not undergo surgery, and who were younger than 18 years of age were excluded from the study. The patients were evaluated in terms of age, gender, type of operation, tumor size, type and histological features, hospital stay, recurrent disease and survival.
Results: Of the 33 patients included in the study, 13 were female and 20 were male, and the median age was 56 (18-86). There were 8 patients with functional tumors, one was somatostatinoma and the others were insulinomas. Enucleation in 7 of the patients; Pancreatectomy was performed in 26 of them. There were three patients whose main lesion was adenocarcinoma and serous cystadenoma, who underwent resection and whose specimen pathology had incidental pNET. We had 23, 7 and 3 patients with grade 1,2 and 3 tumors, respectively. The median value of tumor diameter was 24 (3-80) mm. The median value for hospital stay was 7 (2-50) days. The median value of follow-up was 24 (1-71) months; disease-free survival was 14 (1-71) months.
Conclusions: pNETs are a rare disease that can be detected incidentally and should be carefully managed. Studies with larger series are needed to reach a consensus on the surgical and conservative treatment of pNET.

Keywords: Neuroendocrine tumor, Pancreas, Insulinoma, Enucleation

Kaynakça

  • 1. Maralcan G. Pancreatic Neuroendocrin Tumors.Turkiye Klinikleri J Gen Surg-Special Topics. 2016;9(3):87-90.
  • 2. Mpilla GB, Philip PA, El-Rayes B, Azmi AS. Pancreatic neuroendocrine tumors: Therapeutic challenges and research limitations. World J Gastroenterol. 2020;26(28):4036-4054.
  • 3. Grozinsky-Glasberg S, Mazeh H, Gross DJ. Clinical features of pancreatic neuroendocrine tumors. J Hepatobiliary Pancreat Sci. 2015 Aug;22(8):578-585.
  • 4. Metz DC, Jensen RT. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology 2008;135:1469-1492.
  • 5. Parbhu, S. K., & Adler, D. G. . Pancreatic neuroendocrine tumors: contemporary diagnosis and management. Hospital practice, 2016;44(3),109-119.
  • 6. Giannis D, Moris D, Karachaliou GS, Tsilimigras DI, Karaolanis G, Papalampros A, Felekouras E. Insulinomas: from diagnosis to treatment. A review of the literature. J BUON. 2020;25(3):1302-1314.
  • 7. Serin, K. R, Büyük, M, Güllüoğlu. M, İbiş C, Tekan Y , Özden İ. “Pankreas nöroendokrin tümörlerinin cerrahi tedavisinin uzun dönem sonuçları” . Hitit Medical Journal 2 2020:20-21.
  • 8. Partelli S, Giannone F, Schiavo Lena M, Muffatti F, Andreasi V, et. al. Is the Real Prevalence of Pancreatic Neuroendocrine Tumors Underestimated? A Retrospective Study on a Large Series of Pancreatic Specimens. Neuroendocrinology. 2019;109:165-170.
  • 9. Beane JD, Borrebach JD, Billderback A, Onuma AE, Adam MA, Zureikat AH, Pitt HA. Small pancreatic neuroendocrine tumors: Resect or enucleate? Am J Surg. 2021;222(1):29-34.
  • 10. Jilesen AP, van Eijck CH, Busch OR, van Gulik TM, Gouma DJ, van Dijkum EJ. Postoperative Outcomes of Enucleation and Standard Resections in Patients with a Pancreatic Neuroendocrine Tumor. World J Surg. 2016;40(3):715-728.
  • 11. Klöppel G, Couvelard A, Perren A, Komminoth P, McNicol AM, Nilsson O, et. al. Mallorca Consensus Conference participants; European Neuroendocrine Tumor Society. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: towards a standardized approach to the diagnosis of gastroenteropancreatic neuroendocrine tumors and their prognostic stratification. Neuroenodocrinology. 2009;90:162-166
  • 12. Pavel M, Öberg K, Falconi M, Krenning EP, Sundin A, Perren A, Berruti A; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(7):844-860.
  • 13. Lo GC, Kambadakone A. MR Imaging of Pancreatic Neuroendocrine Tumors. Magn Reson Imaging Clin N Am. 2018;26(3):391-403.

Ayrıntılar

Birincil Dil Türkçe
Konular Tıp
Bölüm Araştırma Makalesi
Yazarlar

Ramazan GÜNDOĞDU> (Sorumlu Yazar)
BAŞKENT ÜNİVERSİTESİ, TURGUT NOYAN UYGULAMA VE ARAŞTIRMA MERKEZİ
0000-0002-8799-3265
Türkiye


Serkan ERKAN>
BAŞKENT ÜNİVERSİTESİ, TURGUT NOYAN UYGULAMA VE ARAŞTIRMA MERKEZİ
0000-0002-4981-5492
Türkiye


Hakan YABANOĞLU>
BAŞKENT ÜNİVERSİTESİ, TURGUT NOYAN UYGULAMA VE ARAŞTIRMA MERKEZİ
0000-0002-1161-3369
Türkiye


M. Eda ERTÖRER>
BAŞKENT ÜNİVERSİTESİ, TURGUT NOYAN UYGULAMA VE ARAŞTIRMA MERKEZİ
0000-0001-7357-8709
Türkiye


Esra Zeynep COŞKUNOĞLU>
BAŞKENT ÜNİVERSİTESİ, TURGUT NOYAN UYGULAMA VE ARAŞTIRMA MERKEZİ
0000-0002-6176-7016
Türkiye


Fatma ÖZARSLAN>
BAŞKENT ÜNİVERSİTESİ, TURGUT NOYAN UYGULAMA VE ARAŞTIRMA MERKEZİ
0000-0002-0634-300X
Türkiye

Destekleyen Kurum Başkent Üniversitesi Araştırma Fonunca desteklenmiştir.
Proje Numarası KA-22-145
Yayımlanma Tarihi 28 Ağustos 2022
Yayınlandığı Sayı Yıl 2022, Cilt 19, Sayı 2

Kaynak Göster

Vancouver Gündoğdu R. , Erkan S. , Yabanoğlu H. , Ertörer M. E. , Coşkunoğlu E. Z. , Özarslan F. Pankreas Nöroendokrin Tümörlerinin Cerrahi Tedavisinde 11 Yıllık Tek Merkez Deneyimi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2022; 19(2): 309-312.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty