Diagnosis, Natural History, Management,tumor biology of Gastrinomas/PETs/Neuroendocrine tumors

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Gastrinomas are the most common symptomatic, malignant pancreatic neuroendocrine tumor (pNETs) in patients with or without MEN1 and sufficient numbers of these patients have been entered into our protocols to allow systematic assessment from an extensive database. Furthermore, with various colloborators this information is often combined or compared to that in other pNET/NET patients. A number of different studies as well as various collaborative guidelines/papers/studies involved in the analyses of major clinical problems in the management of gastrinomas and other pNETs /neuroendocrine tumors were completed this year. During the year information from our prospective studies was used to help formulate two European Neuroendocrine Tumor Networks position papers on unmet needs in patients with pNETs including gastrinomas, as well as other NETs with advanced disease. The ENETs study section for formulating the unmet needs position paper for pNETs was chaired by Dr Jensen and had particular input from the NIH prospective database. Second, a collaborative study with Prof Y-J Chen, Peking University, Beijing China on the potential importance of alterations in chromosome 3p in gastrinomas is now published, which demonstrated , in contrast to a number of smaller studies, no correlation in this chromosomal area with tumor or clinical prognostic features. Third, a collaborative surgical study with Prof J. Norton, Dr A.L.Titian and their colleagues at Stanford University is in final stages of submission dealing with an analysis of results of surgery for locally advanced pNETs. Lastly, data from our prospective database compared with data from the literature was used in formulating and identifying prognostic factors on overall survival and surgical outcomes in patients with pancreatic neuroendocrine tumors in the management of pNETs.