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膵神経内分泌腫瘍(p-NET)

関連論文:
img  25:  Surgical management of pancreatic neuroendocrine tumors.
 
著者: Wataru Kimura, Koji Tezuka, Ichiro Hirai
雑誌名: Surg Today. 2011 Oct;41(10):1332-43. doi: 10.1007/s00595-011-4547-6. Epub 2011 Sep 16.
Abstract/Text This study outlines the surgical management and clinicopathological findings of pancreatic neuroendocrine tumors (P-NETs). There are various surgical options, such as enucleation of the tumor, spleen-preserving distal pancreatectomy, distal pancreatectomy with splenectomy, pancreatoduodenectomy, and duodenum-preserving pancreas head resection. Lymph node dissection is performed for malignant cases. New guidelines and classifications have been proposed and are now being used in clinical practice. However, there are still no clear indications for organ-preserving pancreatic resection or lymph node dissection. Hepatectomy is the first choice for liver metastases of well-differentiated neuroendocrine carcinoma without extrahepatic metastases. On the other hand, cisplatin-based combination therapy is performed as first-line chemotherapy for metastatic poorly differentiated neuroendocrine carcinoma. Other treatment options are radiofrequency ablation, transarterial chemoembolization/embolization, and liver transplantation. Systematic chemotherapy and biotherapy, such as that with somatostatin analogue and interferon-α, are used for recurrence after surgery. The precise surgical techniques for enucleation of the tumor and spleen-preserving distal pancreatectomy are described.

PMID 21922354  Surg Today. 2011 Oct;41(10):1332-43. doi: 10.1007/s00595-011-4547-6. Epub 2011 Sep 16.
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