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Yugang Cheng, Hanxiang Zhan, Lei Wang, Jianwei Xu, Guangyong Zhang, Zongli Zhang, Sanyuan Hu
The incidence rate of pancreatic neuroendocrine neoplasms (pNENs) has increased rapidly in recent years. However, the clinicopathological characteristics of pNENs are poorly understood. Medical records of patients who underwent surgery and were confirmed as pNENs by pathological examination from January 2003 to February 2015 in Qilu Hospital were reviewed retrospectively. A total of 100 patients, 36 males and 64 females, were included with a mean operation age of 46.26 + 13.41 years. Among the 100 cases, 76 had insulinomas and 24 had non-functional pNENs...
October 17, 2016: Frontiers of Medicine
S Partelli, R Cirocchi, S Crippa, L Cardinali, V Fendrich, D K Bartsch, M Falconi
BACKGROUND: The incidence of asymptomatic, sporadic, small non-functioning pancreatic neuroendocrine neoplasms (NF-PNENs) has increased in recent decades. Conservative treatment has been advocated for these tumours. The aim of this study was systematically to evaluate the literature on active surveillance and to compare this with surgical management for asymptomatic sporadic small NF-PNENs. METHODS: PubMed, Embase and the Cochrane Library were searched systematically for studies that compared the active surveillance of asymptomatic, sporadic, small NF-PNENs with surgical management...
October 5, 2016: British Journal of Surgery
Shigeru Horiguchi, Hironari Kato, Hidenori Shiraha, Koichiro Tsutsumi, Naoki Yamamoto, Kazuyuki Matsumoto, Takeshi Tomoda, Daisuke Uchida, Yutaka Akimoto, Syou Mizukawa, Takehiro Tanaka, Koichi Ichimura, Akinobu Takaki, Takahito Yagi, Hiroyuki Okada
BACKGROUND AND AIM: Pathological grading is important in defining the therapeutic strategy in pancreatic neuroendocrine neoplasm (PNEN), but is difficult for unresectable cases. Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is useful in the diagnosis of PNEN, but its usefulness for pathological grading is not well established. No studies have examined the diagnostic ability of dynamic computed tomography (CT) for pathological grading of PNEN. We investigated the usefulness of EUS-FNA and dynamic CT in the diagnosis and pathological grading of PNEN...
September 16, 2016: Journal of Gastroenterology and Hepatology
Tetsuhide Ito, Susumu Hijioka, Toshihiko Masui, Atsuko Kasajima, Yuji Nakamoto, Noritoshi Kobayashi, Izumi Komoto, Masayuki Hijioka, Lingaku Lee, Hisato Igarashi, Robert Thomas Jensen, Masayuki Imamura
Several new developments have occurred in the field of pancreatic neuroendocrine neoplasm (PNEN) recently in Japan. First, the utility of chromogranin A (CgA), useful for the diagnosis and monitoring of the treatment response of neuroendocrine neoplasm (NEN), has been demonstrated in Japan. For PNEN diagnosis and treatment, grading and correct histological diagnosis according to the WHO 2010 classification is important. Regarding the histological diagnosis, the advent of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has enabled correct pathological diagnosis and suitable treatment for the affected tissue...
August 18, 2016: Journal of Gastroenterology
Junli Wu, Feng Guo, Jishu Wei, Zipeng Lu, Jianmin Chen, Wentao Gao, Qiang Li, Kuirong Jiang, Cuncai Dai, Yi Miao
Pancreatic neuroendocrine neoplasmas (PNENs) are classified into functioning & non-functioning tumors. The radical surgery is the only effective way for the cure & long-term survival. For the locoregional resectable tumors, the surgical resection is the first choice of treatment; the surgical procedures include local resection (enucleation) and standard resection. For the insulinomas and non-functioning tumors less than 2 cm, local resection (enucleation),distal pancreatectomy with spleen-preservation or segmental pancreatectomy are the commonly selected procedures...
January 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Sven-Petter Haugvik, Daniel Kaemmerer, Sebastien Gaujoux, Knut Jørgen Labori, Caroline Sophie Verbeke, Ivar Prydz Gladhaug
Pancreatic neuroendocrine neoplasms (PNENs) are rare, accounting for less than 5% of all pancreatic tumors. High-grade pancreatic neuroendocrine carcinomas (hgPNECs) represent about 5% of all PNENs. They show highly aggressive behavior with dismal prognosis. Throughout the last two decades, there has been a notable progress in basic and clinical research of PNENs and a therapeutic trend towards both more aggressive and minimally invasive surgery. Despite these advances, hgPNECs as a distinct clinical entity remains largely unexplored among surgeons...
May 2016: Current Oncology Reports
Sara Massironi, Roberta Elisa Rossi, Alessandra Zilli, Giovanni Casazza, Clorinda Ciafardini, Dario Conte
BACKGROUND: Whether all the small (ø≤20mm) non-functional pancreatic neuroendocrine neoplasms (pNENs) should be routinely resected is unclear. AIM: To assess the overall survival (OS) and progression-free survival (PFS) of patients with small pNENs, followed-up with different management options. MATERIAL AND METHODS: Between 2007-2014, 51 patients were newly diagnosed with pNEN. 15 patients with pNENs ø ≤20 mm underwent an intensive follow-up at 3-month intervals during the first year and then every 6 months (FU pNEN group)...
April 5, 2016: Oncotarget
Caroline L Lopez, Max B Albers, Carmen Bollmann, Jerena Manoharan, Jens Waldmann, Volker Fendrich, Detlef K Bartsch
OBJECTIVE: The role of minimally invasive pancreatic surgery for pancreatic neuroendocrine neoplasms (pNENs) in patients with multiple endocrine neoplasia type 1 (MEN1) is not well defined. The aim of this study was to compare the outcome of minimally invasive versus open pancreatic resections in patients with MEN1. MATERIALS AND METHODS: Prospectively collected data of MEN1 patients who underwent a primary distal pancreatic resection and/or enucleation for non-functioning pNENs or insulinoma were retrospectively analyzed regarding the outcome of minimally invasive or open pancreatic resections...
July 2016: World Journal of Surgery
Sven-Petter Haugvik, Daniel Vodák, Lisbeth Haugom, Eivind Hovig, Ivar Prydz Gladhaug, Sverre Heim, Francesca Micci
OBJECTIVES: The aim of the study was to compare RNA sequencing data of sporadic nonfunctioning pancreatic neuroendocrine neoplasms (PNENs) to identify gene expression patterns that may be important for molecular differentiation of tumor aggressiveness. METHODS: RNA sequencing was performed on samples of sporadic nonfunctioning PNENs, grouped as tumors with mild behavior (nonmetastatic and Ki67 < 5%) or aggressive behavior (metastatic and Ki67 ≥ 5%), on an Illumina Genome Analyzer II platform...
September 2016: Pancreas
Bartosz Szymanowski, Renata Duchnowska, Marek Bilski, Grażyna Łapińska, Beata Hryciuk, Grzegorz Kamiński, Cezary Szczylik
We are reporting a case of a 55-year-old woman who was diagnosed as having a non-functioning pancreatic neuroendocrine neoplasm (NF-PNEN), the World Health Organization (WHO) low grade (G1) with liver metastases. In the staging process the positron emission tomography - computed tomography with Fluorine-18-Fluorodeoxyglucose (F-FDG PET-CT) and spiral CT then the gallium-DOTA-octreotate positron emission tomography - computer tomography (⁶⁸Ga-DOTATATE PET-CT) shown difference in burden of disease. In first line therapy, everolimus (Afinitor®, Novartis Pharma GmbH, Germany) at the oral dose of 10 mg once daily and octreotide long-acting release (Sandostatin LAR®) 30 mg i...
2016: Nuclear Medicine Review. Central & Eastern Europe
Raffaele Pezzilli, Stefano Partelli, Renato Cannizzaro, Nico Pagano, Stefano Crippa, Michele Pagnanelli, Massimo Falconi
BACKGROUND: We systematically evaluate the current evidence regarding Ki-67 as a prognostic factor in pancreatic neuroendocrine neoplasms to evaluate the differences of this marker in primary tumors and in distant metastases as well as the values of Ki-67 obtained by fine needle aspiration and by histology. METHODS: The literature search was carried out using the MEDLINE/PubMed database, and only papers published in the last 10 years were selected. RESULTS: The pancreatic tissue suitable for Ki-67 evaluation was obtained from surgical specimens in the majority of the studies...
March 2016: Advances in Medical Sciences
Susumu Hijioka, Kazuo Hara, Nobumasa Mizuno, Hiroshi Imaoka, Vikram Bhatia, Mohamed A Mekky, Kenichi Yoshimura, Tsukasa Yoshida, Nozomi Okuno, Nobuhiro Hieda, Masahiro Tajika, Tsutomu Tanaka, Makoto Ishihara, Yasushi Yatabe, Yasuhiro Shimizu, Yasumasa Niwa, Kenji Yamao
BACKGROUND: Multiple studies have investigated sampling adequacy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for pancreatic neuroendocrine neoplasms (pNENs). However, none have described the diagnostic performance of EUS-FNA for pNENs, or the influencing factors. The aim of this study was to evaluate the diagnostic accuracy of EUS-FNA, with post-operative pathological diagnosis as the gold standard, and factors predictive of inadequate EUS sampling. METHODS: From 1998 to 2014, a total of 698 patients underwent pancreatic resection and 1455 patients underwent EUS-FNA sampling for pancreatic lesions...
September 2016: Journal of Gastroenterology
Stefano Partelli, Domenico Tamburrino, Caroline Lopez, Max Albers, Anna Caterina Milanetto, Claudio Pasquali, Marco Manzoni, Christos Toumpanakis, Giuseppe Fusai, Detlef Bartsch, Massimo Falconi
BACKGROUND: The aim of this study was to evaluate the efficacy of conservative treatment for nonfunctioning pancreatic neuroendocrine neoplasms (NF-PNEN) ≤2 cm in multiple endocrine neoplasia type 1 (MEN1)-affected patients compared with surgical treatment. METHODS: The databases of 4 tertiary referral institutions (San Raffaele Scientific Institute, Milan; Philipps-Universität Marburg, Marburg; University of Padua, Padua; Royal Free Hospital, London) were analyzed...
2016: Neuroendocrinology
Dominik Wiese, Katharina Kampe, Jens Waldmann, Anna E Heverhagen, Detlef K Bartsch, Volker Fendrich
CONTEXT: Patients with pancreatic neuroendocrine neoplasia (pNEN) show great variability in prognosis and treatment response. Additional prognostic markers might help in individual therapeutic decision making. OBJECTIVE: The objective of the study was to investigate the association between preoperative plasma levels of C-reactive protein (CRP) and overall survival (OS) in pNEN. DESIGN: This was a single-center, retrospective analysis of long-term prospective patient-database...
March 2016: Journal of Clinical Endocrinology and Metabolism
Sebastian Krug, Michael Boch, Hanna Daniel, Wilhelm Nimphius, Daniela Müller, Patrick Michl, Anja Rinke, Thomas Matthias Gress
BACKGROUND AND AIM: Chemotherapy with streptozocin (STZ) in combination with 5-FU or doxorubicin (Dox) represents a standard of care for patients with metastatic pancreatic neuroendocrine neoplasms (pNEN). However, predictive markers for patient selection are still missing. The aim of this study was a retrospective evaluation of the clinicopathological characteristics of pNEN patients receiving STZ-based chemotherapies and to identify predictive and prognostic markers. PATIENTS AND METHODS: We retrospectively analyzed 77 patients treated at our center between 1995 and 2013...
2015: PloS One
M Koren S Kinova
Insulinomas are the most common functioning pancreatic neuroendocrine neoplasms (pNENs), developed mainly from pancreatic islet cells. More than 90% of insulinomas are sporadic, benign and small sized. Autonomous production of insulin results in neuroglycopenic and adrenergic symptomatology with potential lethality. Surgery remains the only curative treatment with a high success rate. Preoperative tumor localization is challenging, but important for appropriate surgical approach. Metastatic forms represent a challenge, mainly on the field of therapy, with the need of tumor burden reduction and glycemia stabilization...
2015: Neoplasma
Zane Simtniece, Andrejs Vanags, Ilze Strumfa, Maris Sperga, Ervins Vasko, Peteris Prieditis, Peteris Trapencieris, Janis Gardovskis
The study represents a comprehensive retrospective morphological and immunohistochemical profiling of pancreatic neuroendocrine neoplasms (PNENs) in order to reveal the associations between morphological and molecular parameters. The local tumour spread (T), presence of metastases in regional lymph nodes (N) and distant organs (M), tumour grade (G) and resection line status (R) by pathology findings (pTNMGR), mitotic activity, perineural, vascular and lymphatic invasion were assessed in 16 surgically resected PNENs...
June 2015: Polish Journal of Pathology: Official Journal of the Polish Society of Pathologists
Daijiro Morimoto, Toyohiko Isu, Kyongsong Kim, Atsushi Sugawara, Kazuyoshi Yamazaki, Yasuhiro Chiba, Naotaka Iwamoto, Masanori Isobe, Akio Morita
Peroneal nerve entrapment neuropathy (PNEN) is one cause of numbness and pain in the lateral lower thigh and instep, and of motor weakness of the extensors of the toes and ankle. We report a less invasive surgical procedure performed under local anesthesia to treat PNEN and our preliminary outcomes. We treated 22 patients (33 legs), 7 men and 15 women, whose average age was 66 years. The mean postoperative follow-up period was 40 months. All patients complained of pain or paresthesia of the lateral aspect of affected lower thigh and instep; all manifested a Tinel-like sign at the entrapment point...
2015: Neurologia Medico-chirurgica
Alexander D J Baur, Marianne Pavel, Vikas Prasad, Timm Denecke
Pancreatic neuroendocrine neoplasms (pNEN) are rare malignancies arising from neuroendocrine cells of the pancreas. Functional tumors can present with specific clinical syndromes due to hormonal secretion. These tumors can present as incidental findings on imaging performed for unrelated purposes or they are diagnosed when workup is initiated in patients with specific syndromes or metastases. This article presents an overview of available imaging techniques focusing on computed tomography and magnetic resonance imaging...
March 2016: Acta Radiologica
Xian-sheng Lin, Cheng-lin Zhu, Chen-hai Liu, Fang Xie, Hang-cheng Zhou, Qiang Huang
BACKGROUND/AIMS: There are few large sample, single-center series that focus on the methods of diagnosis, treatment and long-term survival of patients with Pancreatic neuroendocrine neoplasms (pNENs). METHODOLOGY: Forty-seven patients with pNENs treated at Anhui province hospital affliated of Anhui Medical University during January 2002 to December 2013 were analyzed retrospectively. Clinical data were collected and statistically analyzed. RESULTS: The sensitivity of abdominal ultrasound, CT and MRI was 71...
November 2014: Hepato-gastroenterology
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