Evaluation of Outcomes Following Surgery for Locally Advanced Pancreatic Neuroendocrine Tumors

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Abstract
Pancreatic neuroendocrine tumors (PNETs) are a heterogeneous group of epithelial neoplasms that comprise 2% to 7% of all pancreatic tumors.1,2 As many as 10% of PNETs may arise in association with a hereditary syndrome, most commonly multiple endocrine neoplasia type 1 (MEN1); however, the majority of PNETs occur sporadically.3,4 PNETs can be classified as either functional or nonfunctional depending on whether they secrete a hormone that usually causes a clinical syndrome. Given that most PNETs (60%-90%) are nonfunctional and therefore are not associated with secretion of hormones, patients are unfortunately usually diagnosed with advanced disease for which surgery may not be possible.5,6 Complete surgical resection of a PNET has been suggested to be the only potentially curative treatment.7 Recently, the European Neuroendocrine Tumor Society identified that assessment of the effects of surgical treatment for locally advanced PNETs is a major unmet need.1

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