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Ester Osher, Erez Scapa, Joseph Klausner, Yona Greenman, Karen Tordjman, Alla Melhem, Ido Nachmany, Yael Sofer, Ravit Geva, Arye Blachar, Naftali Stern, Erwin Santo
OBJECTIVE: To improve the preoperative assessment of pancreatic incidentalomas (PIs) by analysis of 1 index case and characterization of the published features of intrapancreatic accessory spleen (IPAS) compared to pancreatic neuroendocrine tumor (PNET). METHODS: A search of the literature using the online database MEDLINE. RESULTS: In all, 46 cases of IPAS have been described to date: 17 were "presumed" as IPAS based on technetium-99m (Tc-99m) scanning, fine-needle aspiration (FNA) stain for CD8, or contrast-enhanced sonography; 29 were misdiagnosed as PNET and underwent surgery...
July 2016: Endocrine Practice
Alexander Kaltenborn, Svenja Matzke, Moritz Kleine, Till Krech, Wolf Ramackers, Florian W R Vondran, Jürgen Klempnauer, Hüseyin Bektas, Harald Schrem
BACKGROUND: This study strives to define prognostic models for outcome after surgery for malignant pancreatic neuroendocrine tumors. METHODS: Forty-one patients were included. Prognostic models for mortality and disease recurrence were developed with multivariate binary logistic regression. RESULTS: The proposed prognostic model for tumor recurrence risk after surgery in percentage (AUROC = 0.774, 95%CI = 0.611-0.937) is: Risk in % = Exp(Y)/(1 + Exp(Y)), with Y = -4...
February 2016: Journal of Surgical Oncology
Anneke P J Jilesen, Casper H J van Eijck, Olivier R C Busch, Thomas M van Gulik, Dirk J Gouma, Els J M Nieveen van Dijkum
BACKGROUND: Either enucleation or more extended resection is performed to treat patients with pancreatic neuroendocrine tumor (pNET). Aim was to analyze the postoperative complications for each operation separately. Furthermore, independent risk factors for complications and incidence of pancreatic insufficiency were analyzed. METHODS: Retrospective all resected patients from two academic hospitals in The Netherlands between 1992 and 2013 were included. Postoperative complications were scored by both ISGPS and Clavien-Dindo criteria...
March 2016: World Journal of Surgery
Nicolas Regenet, Nicolas Carrere, Guillaume Boulanger, Loic de Calan, Marine Humeau, Vincent Arnault, Jean-Louis Kraimps, Murielle Mathonnet, Patrick Pessaux, Gianluca Donatini, Aurelien Venara, Niki Christou, Philippe Bachelier, Antoine Hamy, Eric Mirallié
BACKGROUND: Nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) are often discovered at a small size. No clear consensus exists on the management of NF-PNETs ≤ 2 cm. The aim of our study was to determine the prognostic value of indicators of malignancy in sporadic NF-PNETs ≤ 2 cm. METHODS: Eighty patients were evaluated retrospectively in 7 French University Hospital Centers. Patients were managed by operative resection (operative group [OG]) or observational follow-up (non-OG [NOG])...
March 2016: Surgery
Alex M Rosenberg, Patricia Friedmann, Jaydira Del Rivero, Steven K Libutti, Amanda M Laird
BACKGROUND: Sporadic, nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) are diagnosed with increasing frequency. We compared the risk of tumor growth, metastasis, and mortality between patients treated versus those treated expectantly. METHOD: A retrospective study of patients seen at our institution with sporadic NF-PNETs, with ≥ 12 months of follow-up. Kaplan-Meier analysis was performed. RESULTS: Between 1999 and 2014, 35 patients with an incidentally discovered nonfunctional PNET were identified...
January 2016: Surgery
Jill K Onesti, Lawrence A Shirley, Neil D Saunders, Gail W Davidson, Mary E Dillhoff, Hooman Khabiri, Gregory E Guy, Joshua D Dowell, Carl R Schmidt, Manisha H Shah, Mark Bloomston
INTRODUCTION: We hypothesized that an elevated preoperative alkaline phosphatase (AP) predicted worse outcomes for patients undergoing transarterial chemoembolization (TACE) for neuroendocrine tumor (NET) liver metastases. METHODS: We reviewed all patients who underwent TACE for metastatic NET between 2009 and 2013. Survival was evaluated using preprocedure variables. RESULTS: One hundred and nine patients underwent 210 TACE procedures. The average age was 57...
March 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Xavier M Keutgen, Naris Nilubol, Joanne Glanville, Samira M Sadowski, David J Liewehr, David J Venzon, Seth M Steinberg, Electron Kebebew
BACKGROUND: Nonfunctioning pancreatic neuroendocrine tumors (NFpNET) present with distant metastases in up to 50% of patients. It is unknown whether removal of the primary tumor in patients with NFpNET and metastases is beneficial. METHODS: We used the Surveillance, Epidemiology, and End Results database to identify patients with NFpNET and distant metastases. The primary outcome measure in this study was overall survival. RESULTS: We identified 882 patients with metastatic NFpNET who had survival data; 303 (34%) patients had operative removal of their primary tumor of which 243 (80%) were grade I or II...
January 2016: Surgery
Dimitrios Xourafas, Ali Tavakkoli, Thomas E Clancy, Stanley W Ashley
BACKGROUND: The latest studies on surgical and cost-analysis outcomes after laparoscopic distal pancreatectomy (LDP) highlight mixed and insufficient results. Whereas several investigators have compared surgical outcomes of LDP vs. open distal pancreatectomy (ODP) for adenocarcinomas, few similar studies have focused on pancreatic neuroendocrine tumors (PNETs). METHODS: We reviewed the medical records of PNET patients undergoing distal pancreatectomy between 2004 and 2014...
May 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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