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Update on Surgical Management of Small Bowel Neuroendocrine Tumors.

Authors
  • Moris, Demetrios1
  • Ntanasis-Stathopoulos, Ioannis2
  • Tsilimigras, Diamantis I2
  • Vagios, Stylianos2
  • Karamitros, Andreas2
  • Karaolanis, Georgios2
  • Griniatsos, John2
  • Papalampros, Alexandros2
  • Papaconstantinou, Ioannis3
  • Glantzounis, Georgios K4
  • Spartalis, Eleftherios2
  • Blazer, Dan G 3rd5
  • Felekouras, Evangelos2
  • 1 Department of Surgery, Duke University Medical Center, Duke University, Durham, NC, U.S.A. [email protected]
  • 2 First Department of Surgery, National and Kapodistrian University of Athens, Medical School, Laiko Hospital, Athens, Greece. , (Greece)
  • 3 Second Department of Surgery, National and Kapodistrian University of Athens, Aretaieio University Hospital, Athens, Greece. , (Greece)
  • 4 Department of Surgery, Ioannina University Hospital, Ioannina, Greece. , (Greece)
  • 5 Department of Surgery, Duke University Medical Center, Duke University, Durham, NC, U.S.A.
Type
Published Article
Journal
Anticancer Research
Publisher
International Institute of Anticancer Research
Publication Date
Mar 01, 2018
Volume
38
Issue
3
Pages
1267–1278
Identifiers
PMID: 29491050
Source
Medline
Keywords
License
Unknown

Abstract

The widespread use of endoscopy and imaging in combination with the continuous update of the staging systems for neuroendocrine tumors has led to an increase in the incidence of small intestinal neuroendocrine tumors (si-NENs) globally. Despite high survival rates, severe complications may occur even in early stages due to the anatomic location of the primary site and the desmoplastic reaction. Surgery plays a central role in the management of patients with si-NENs. Excision of locoregional disease along with extensive lymph node dissection should be performed in fit patients, even in the presence of metastases. Multimodality treatment of liver metastases includes hepatectomy, ablative techniques and liver transplantation. Hormone therapy with somatostatine analogs is of high importance for symptomatic control; special caution should be exercised both pre- and intra-operatively. A multidisciplinary approach is essential in order to provide personalized therapeutics for patients with si-NENs. Clinical research and specialization in this field should be further encouraged.

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