Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Pancreatic Neuroendocrine Tumors: What Is the Best Surgical Option?

Renato Patrone
* ORCID logo ,
Federico Maria Mongardini
ORCID logo ,
Alessandra Conzo
,
Chiara Cacciatore
,
Giovanni Cozzolino
,
Antonio Catauro
,
Eduardo Lanza
,
Francesco Izzo
ORCID logo ,
Andrea Belli
ORCID logo ,
Raffaele Palaia
,
Luigi Flagiello
,
Ferdinando De Vita
,
Ludovico Docimo
,
Giovanni Conzo
Version 1 : Received: 9 April 2024 / Approved: 9 April 2024 / Online: 10 April 2024 (13:05:26 CEST)

How to cite: Patrone, R.; Mongardini, F.M.; Conzo, A.; Cacciatore, C.; Cozzolino, G.; Catauro, A.; Lanza, E.; Izzo, F.; Belli, A.; Palaia, R.; Flagiello, L.; De Vita, F.; Docimo, L.; Conzo, G. Pancreatic Neuroendocrine Tumors: What Is the Best Surgical Option?. Preprints 2024, 2024040692. https://doi.org/10.20944/preprints202404.0692.v1 Patrone, R.; Mongardini, F.M.; Conzo, A.; Cacciatore, C.; Cozzolino, G.; Catauro, A.; Lanza, E.; Izzo, F.; Belli, A.; Palaia, R.; Flagiello, L.; De Vita, F.; Docimo, L.; Conzo, G. Pancreatic Neuroendocrine Tumors: What Is the Best Surgical Option?. Preprints 2024, 2024040692. https://doi.org/10.20944/preprints202404.0692.v1

Abstract

Background: Pancreatic neuroendocrine tumors (pNETs) represents a rare subset of pancreatic cancer. Functional tumors caused hormonal changes and clinical syndromes, while non-functional ones are often diagnosed late. Surgical management need a multidisciplinary planning, involving enucleation, distal pancreatectomy with or without spleen preserving, cen-tral pancreatectomy, pancreaticoduodectomy or total pancreatectomy. Minimally invasive ap-proach increased in the last decade compared to the open technique. The aim of this study is to analyze current diagnostic and surgical trends for pNETs, to identify better interventions and their outcomes. Methods: The study adhered to PRISMA guidelines, conducting a systematic review of literature from May 2008 to March 2022 across multiple databases. Several combinations of keywords was used ("NET", "pancreatic", "surgery", "laparoscopic", "minimally invasive", "robotic”, “enuclea-tion”,“parenchima sparing”) and relevant article references was manually checked. Manuscript quality was evaluated. Results: The study screened 3867 manuscripts, twelve studies were selected, primarily from Ita-ly, the United States, and China. A total of 7767 surgical treated patients was collected from 160 included centers. The mean age was 56,3 y.o. Enucleations (EN) and distal pancreatectomy (DP) was the most common performed surgery and represents 43.4% and 38.6% of the total interven-tions, respectively. Pancreatic fistula, post operative bleeding, re-operation and follow up was recorded and analyzed. Conclusions: Enucleation show better postoperative outcomes and lower mortality rates com-pared to pancreaticoduodenectomy (PD) or distal pancreatectomy (DP), despite similar risks of postoperative pancreatic fistula (POPF). DP was preferred over enucleation for pancreas body-tail, while laparoscopic enucleation is better for head pNETs.

Keywords

pNET; Neuroendocrine tumors; Pancreas tumor; pancreatic cancer; enucleation; Pancreatectomy

Subject

Medicine and Pharmacology, Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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