Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are heterogeneous lesions with varied presentations, clinical courses, and prognoses. Some of these neoplasms display a very benign behavior, while others are extremely aggressive. Appropriately determining which patients will benefit from curative resection attempts is often difficult. While indications for resection of metastatic GEP-NENs continues to evolve, those with high grade (G3) lesions have not traditionally thought to benefit from curative intent surgery.
- Chen H.
- Hardacre J.M.
- Uzar A.
- Cameron J.L.
- Choti M.A.
Isolated liver metastases from neuroendocrine tumors: does resection prolong survival?.
J Am Coll Surg. 1998; 187: 88-92
2The authors of this paper question this paradigm and suggest an intent-to-cure resection is beneficial to highly selected patients with stage IV G3 GEP-NENs.
- Limbach K.E.
- Pommier S.E.J.
- Dewey E.
- Leon E.
- Pommier R.F.
Neuroendocrine metastases to the ovaries are significantly associated with small bowel neuroendocrine tumors and carcinomatosis.
Am J Surg. 2020; 219: 795-799
3Their retrospective multi-site review of 15 patients reports an increase in expected median overall survival (OS) for resected patients when compared to historical controls treated with systemic treatment only. They astutely recognize the studies’ limitations in that it is a highly selected cohort in which an intent-to-treat analysis is not possible to perform. Despite these shortcomings, a few key findings are very enlightening.
- Merola E.
- Falconi M.
- Rinke A.
- et al.
Radical intended surgery for highly selected stage IV neuroendocrine neoplasms G3.
Am J Surg. 2020;
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- Isolated liver metastases from neuroendocrine tumors: does resection prolong survival?.J Am Coll Surg. 1998; 187: 88-92
- Neuroendocrine metastases to the ovaries are significantly associated with small bowel neuroendocrine tumors and carcinomatosis.Am J Surg. 2020; 219: 795-799
- Radical intended surgery for highly selected stage IV neuroendocrine neoplasms G3.Am J Surg. 2020;
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- Progression and survival results after radical hepatic metastasectomy of indolent advanced neuroendocrine neoplasms (NENs) supports an aggressive surgical approach.Surgery. 2011; 149: 209-220
- The high-grade (WHO G3) pancreatic neuroendocrine tumor category is morphologically and biologically heterogenous and includes both well differentiated and poorly differentiated neoplasms.American Journal of Surgical Pathology. vol. 39. Lippincott Williams and Wilkins, 2015: 683-690
- Are G3 ENETS neuroendocrine neoplasms heterogeneous?.Endocr Relat Canc. 2013; 20: 649-657
Published online: May 28, 2020
Accepted: May 6, 2020
Received in revised form: May 5, 2020
Received: May 5, 2020
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