Strategy for pancreatic endocrine tumors.
Strategy for pancreatic endocrine tumors.
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发表时间：
2000-03
影响因子：
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通讯作者：
Takahiro Sato;Koji Konishi;H. Kimura;K. Maeda;K. Yabushita;M. Tsuji;H. Demachi;A. Miwa
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作者：
Takahiro Sato;Koji Konishi;H. Kimura;K. Maeda;K. Yabushita;M. Tsuji;H. Demachi;A. Miwa
背景/目的胰腺内分泌肿瘤是一种罕见的疾病，对于胰腺内分泌肿瘤的肝转移尚无标准的治疗方法。本研究对胰腺内分泌肿瘤的治疗进行了评价。方法对13例胰腺内分泌肿瘤进行手术治疗。所有原发肿瘤均被完全切除。4例患者发现肝转移。2例患者行部分肝切除。另外2例同步不可切除肝转移患者行脂醇-经导管动脉栓塞治疗。结果无肝转移患者存活无复发（最长18.8年，平均随访9.2年）。切除的同时性孤立性肝转移患者术后5个月死于复发性多发肝转移。另一例完全切除异时性肝转移的患者存活13.9年。2例无法切除的大量肝转移患者，经脂醇-经导管动脉栓塞后，肿瘤坏死率均在90%以上，血清胃泌素水平恢复正常。结论完全切除肝转移是有利的，而脂醇-经导管动脉栓塞对于胰腺内分泌肿瘤不可切除的肝转移是有效的。完全切除原发部位是推荐的，即使在病例无法切除的大量肝转移。
BACKGROUND/AIMS The endocrine tumors of the pancreas are rare diseases and there is no established standard therapy for the liver metastasis of pancreatic endocrine tumors. In this study, the therapy for the pancreatic endocrine tumors was evaluated. METHODOLOGY The endocrine pancreas tumors of 13 patients had been surgically treated. All primary tumors were completely resected. The liver metastasis was recognized in 4 patients. Partial resection of the liver was performed in 2 patients. Lipiodol-transcatheter arterial embolization was performed for synchronous unresectable liver metastases in the other 2 patients. RESULTS The patients with no liver metastases survived without recurrence (max: 18.8 yr; mean follow-up: 9.2 yr). The patient with resected synchronous solitary liver metastasis died of recurrent multiple liver metastases 5 months after surgery. The other patient with the metachronous liver metastasis completely resected survived 13.9 years. In the 2 patients with unresectable numerous liver metastases, after lipiodol-transcatheter arterial embolization, tumor necrosis rate was more than 90% in both cases and serum gastrin level was normalized. CONCLUSIONS Complete resection of liver metastasis is favorable, whereas lipiodol-transcatheter arterial embolization is effective for unresectable liver metastases from pancreatic endocrine tumors as palliation. Complete resection of the primary site is recommended even in the cases with unresectable numerous liver metastases.