Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension
Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Dumont, F. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2015 |
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| Schlagwörter: |
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| Anmerkung: |
© Société Internationale de Chirurgie 2015 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 39(2015), 8 vom: 25. März, Seite 1974-1980 |
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| Übergeordnetes Werk: |
volume:39 ; year:2015 ; number:8 ; day:25 ; month:03 ; pages:1974-1980 |
| Links: |
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| DOI / URN: |
10.1007/s00268-015-3030-8 |
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SPR003453405 |
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| 520 | |a Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed. Results The median age was 55 years (25–75). The median tumor size was 7.5 cm (3–20). Thirty four (80.9 %) patients were metastatic mainly in the liver (n = 33, 79 %) with a frequent (n = 16, 38.1 %) involvement >20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (n = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; p = 0.64). The 5-year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively. Conclusion PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection. | ||
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10.1007/s00268-015-3030-8 doi (DE-627)SPR003453405 (SPR)s00268-015-3030-8-e DE-627 ger DE-627 rakwb eng Dumont, F. verfasserin aut Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2015 Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed. Results The median age was 55 years (25–75). The median tumor size was 7.5 cm (3–20). Thirty four (80.9 %) patients were metastatic mainly in the liver (n = 33, 79 %) with a frequent (n = 16, 38.1 %) involvement >20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (n = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; p = 0.64). The 5-year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively. Conclusion PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection. Pancreatic Fistula (dpeaa)DE-He213 Splenic Vein (dpeaa)DE-He213 Incomplete Resection (dpeaa)DE-He213 Local Complication (dpeaa)DE-He213 Primary Tumor Resection (dpeaa)DE-He213 Goudard, Y. aut Caramella, C. aut Goéré, D. aut Baudin, E. aut Elias, D. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2015), 8 vom: 25. März, Seite 1974-1980 (DE-627)SPR003391159 nnns volume:39 year:2015 number:8 day:25 month:03 pages:1974-1980 https://dx.doi.org/10.1007/s00268-015-3030-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2015 8 25 03 1974-1980 |
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10.1007/s00268-015-3030-8 doi (DE-627)SPR003453405 (SPR)s00268-015-3030-8-e DE-627 ger DE-627 rakwb eng Dumont, F. verfasserin aut Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2015 Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed. Results The median age was 55 years (25–75). The median tumor size was 7.5 cm (3–20). Thirty four (80.9 %) patients were metastatic mainly in the liver (n = 33, 79 %) with a frequent (n = 16, 38.1 %) involvement >20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (n = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; p = 0.64). The 5-year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively. Conclusion PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection. Pancreatic Fistula (dpeaa)DE-He213 Splenic Vein (dpeaa)DE-He213 Incomplete Resection (dpeaa)DE-He213 Local Complication (dpeaa)DE-He213 Primary Tumor Resection (dpeaa)DE-He213 Goudard, Y. aut Caramella, C. aut Goéré, D. aut Baudin, E. aut Elias, D. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2015), 8 vom: 25. März, Seite 1974-1980 (DE-627)SPR003391159 nnns volume:39 year:2015 number:8 day:25 month:03 pages:1974-1980 https://dx.doi.org/10.1007/s00268-015-3030-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2015 8 25 03 1974-1980 |
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10.1007/s00268-015-3030-8 doi (DE-627)SPR003453405 (SPR)s00268-015-3030-8-e DE-627 ger DE-627 rakwb eng Dumont, F. verfasserin aut Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2015 Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed. Results The median age was 55 years (25–75). The median tumor size was 7.5 cm (3–20). Thirty four (80.9 %) patients were metastatic mainly in the liver (n = 33, 79 %) with a frequent (n = 16, 38.1 %) involvement >20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (n = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; p = 0.64). The 5-year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively. Conclusion PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection. Pancreatic Fistula (dpeaa)DE-He213 Splenic Vein (dpeaa)DE-He213 Incomplete Resection (dpeaa)DE-He213 Local Complication (dpeaa)DE-He213 Primary Tumor Resection (dpeaa)DE-He213 Goudard, Y. aut Caramella, C. aut Goéré, D. aut Baudin, E. aut Elias, D. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2015), 8 vom: 25. März, Seite 1974-1980 (DE-627)SPR003391159 nnns volume:39 year:2015 number:8 day:25 month:03 pages:1974-1980 https://dx.doi.org/10.1007/s00268-015-3030-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2015 8 25 03 1974-1980 |
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10.1007/s00268-015-3030-8 doi (DE-627)SPR003453405 (SPR)s00268-015-3030-8-e DE-627 ger DE-627 rakwb eng Dumont, F. verfasserin aut Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2015 Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed. Results The median age was 55 years (25–75). The median tumor size was 7.5 cm (3–20). Thirty four (80.9 %) patients were metastatic mainly in the liver (n = 33, 79 %) with a frequent (n = 16, 38.1 %) involvement >20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (n = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; p = 0.64). The 5-year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively. Conclusion PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection. Pancreatic Fistula (dpeaa)DE-He213 Splenic Vein (dpeaa)DE-He213 Incomplete Resection (dpeaa)DE-He213 Local Complication (dpeaa)DE-He213 Primary Tumor Resection (dpeaa)DE-He213 Goudard, Y. aut Caramella, C. aut Goéré, D. aut Baudin, E. aut Elias, D. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2015), 8 vom: 25. März, Seite 1974-1980 (DE-627)SPR003391159 nnns volume:39 year:2015 number:8 day:25 month:03 pages:1974-1980 https://dx.doi.org/10.1007/s00268-015-3030-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2015 8 25 03 1974-1980 |
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10.1007/s00268-015-3030-8 doi (DE-627)SPR003453405 (SPR)s00268-015-3030-8-e DE-627 ger DE-627 rakwb eng Dumont, F. verfasserin aut Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2015 Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed. Results The median age was 55 years (25–75). The median tumor size was 7.5 cm (3–20). Thirty four (80.9 %) patients were metastatic mainly in the liver (n = 33, 79 %) with a frequent (n = 16, 38.1 %) involvement >20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (n = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; p = 0.64). The 5-year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively. Conclusion PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection. Pancreatic Fistula (dpeaa)DE-He213 Splenic Vein (dpeaa)DE-He213 Incomplete Resection (dpeaa)DE-He213 Local Complication (dpeaa)DE-He213 Primary Tumor Resection (dpeaa)DE-He213 Goudard, Y. aut Caramella, C. aut Goéré, D. aut Baudin, E. aut Elias, D. aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 39(2015), 8 vom: 25. März, Seite 1974-1980 (DE-627)SPR003391159 nnns volume:39 year:2015 number:8 day:25 month:03 pages:1974-1980 https://dx.doi.org/10.1007/s00268-015-3030-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 39 2015 8 25 03 1974-1980 |
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Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension |
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Dumont, F. |
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World Journal of Surgery |
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Dumont, F. Goudard, Y. Caramella, C. Goéré, D. Baudin, E. Elias, D. |
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Dumont, F. |
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10.1007/s00268-015-3030-8 |
| title_sort |
therapeutic strategies for advanced pancreatic neuroendocrine tumors with segmental portal hypertension |
| title_auth |
Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension |
| abstract |
Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed. Results The median age was 55 years (25–75). The median tumor size was 7.5 cm (3–20). Thirty four (80.9 %) patients were metastatic mainly in the liver (n = 33, 79 %) with a frequent (n = 16, 38.1 %) involvement >20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (n = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; p = 0.64). The 5-year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively. Conclusion PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection. © Société Internationale de Chirurgie 2015 |
| abstractGer |
Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed. Results The median age was 55 years (25–75). The median tumor size was 7.5 cm (3–20). Thirty four (80.9 %) patients were metastatic mainly in the liver (n = 33, 79 %) with a frequent (n = 16, 38.1 %) involvement >20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (n = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; p = 0.64). The 5-year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively. Conclusion PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection. © Société Internationale de Chirurgie 2015 |
| abstract_unstemmed |
Background Pancreatic neuroendocrine tumors (PNET) locally advanced may lead to significant local symptoms especially segmental portal hypertension (SPH) with risk of bleeding. The aim of our study was to evaluate the role of SPH on the PNET management in an expert center. Methods Forty-two patients treated for locally advanced PNET with SPH between January 1984 and December 2012 were retrospectively analyzed. Results The median age was 55 years (25–75). The median tumor size was 7.5 cm (3–20). Thirty four (80.9 %) patients were metastatic mainly in the liver (n = 33, 79 %) with a frequent (n = 16, 38.1 %) involvement >20 %. The surgery was impossible because of SPH in 7 (16.6 %) cases. Pancreatic resection was performed in 28 (66.7 %) cases by distal pancreatectomy. Neoadjuvant chemotherapy (n = 24, 57 %) had no impact on SPH with no modification of collateral circulation. Among operated on patients, complete macroscopic resection was obtained in 19 (67.8 %) patients. The mortality and severe morbidity rate was respectively 3.6 and 18 %. Five year overall survival (OS) was similar in operated and no operated patients. (61 %; p = 0.64). The 5-year OS was 77.9 or 55.4 % in patients who underwent a complete or incomplete macroscopic resection of primary and metastases, respectively. Conclusion PNET resection associated with SPH is feasible with a low morbimortality. SPH was not improved by chemotherapy. Prolonged survival was observed after complete macroscopic resection. © Société Internationale de Chirurgie 2015 |
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Therapeutic Strategies for Advanced Pancreatic Neuroendocrine Tumors with Segmental Portal Hypertension |
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