Pancreatic neuroendocrine neoplasms (PNENs) affect over 80% of patients with multiple endocrine neoplasia type 1 (MEN1). Surgery is usually the therapy of choice, but the real immediate and long-term therapeutic benefit of a partial extensive pancreatic resection remains controversial. We analyzed, in 43 PNEN MEN1 patients who underwent 19 pancreaticoduodenectomies (PD), 19 distal pancreatectomies (DP), and 5 minimal pancreatectomies, the prevalence of surgery-derived early complications and post-operative pancreatic sequelae, and the PNEN relapse-free survival time after surgery, comparing major (PD+DP) and minimal pancreatic surgeries. No post-operative mortality was observed. Metastatic cancers were found in 12 cases, prevalently from duodenal gastrinoma. Long-term cure of endocrine syndromes, by the 38 major pancreatic resections, was obtained in 78.9% of gastrinomas and 92.9% of insulinomas. In only one patient, hepatic metastases, due to gastrinoma, progressed to death. Out of the 38 major surgeries, only one patient was reoperated for the growth of a new PNEN in the remnant pancreas. No functioning PNEN persistence was reported in the five minimal pancreatic surgeries, PNEN relapse occurred in 60% of patients, and 40% of cases needed further pancreatic resection for tumor recurrence. No significant difference in PNEN relapse-free survival time after surgery was found between major and minimal pancreatic surgeries.
胰腺神经内分泌肿瘤（PNENs）影响超过80%的多发性内分泌腺瘤病1型（MEN1）患者。手术通常是首选治疗方法，但部分广泛胰腺切除术的实际即时及长期治疗效果仍存在争议。本研究对43例接受手术的PNEN MEN1患者进行分析，其中19例行胰十二指肠切除术（PD），19例行远端胰腺切除术（DP），5例行局限性胰腺切除术。通过对比扩大胰腺手术（PD+DP）与局限性手术，我们评估了手术相关早期并发症及术后胰腺后遗症的发生率，以及术后PNEN无复发生存时间。研究期间未观察到术后死亡病例。共发现12例转移性癌变，主要源自十二指肠胃泌素瘤。通过38例扩大胰腺切除术，内分泌综合征的长期治愈率在胃泌素瘤中达78.9%，胰岛素瘤中达92.9%。仅1例患者因胃泌素瘤肝转移进展导致死亡。在38例扩大手术中，仅1例因残留胰腺新生PNEN生长需再次手术。5例局限性胰腺手术均未出现功能性PNEN持续存在，但60%患者出现PNEN复发，40%病例因肿瘤复发需再次胰腺切除。扩大手术与局限性手术后PNEN无复发生存时间未见显著差异。
肿瘤(癌症)患者之家