Management of small, asymptomatic, non-functioning pancreatic neuroendocrine tumours: follow-up, ablation, or surgery?
Krzysztof DąbkowskiTeresa StarzyńskaPublished in: Endokrynologia Polska (2022)
Non-functioning pancreatic neuroendocrine tumours (NF-pNETs) are potentially malignant neoplasms that are detected with increasing frequency. The management of small (≤ 2 cm) asymptomatic NF-pNETs remains an area of controversy and clinical dilemma. Follow-up seems to be a reasonable strategy because of the relatively limited metastatic potential of these tumours, the good clinical prognosis, and considering the high complication rate associated with surgery. However, some studies show metastatic potential of these tumours, fuelling an ongoing debate in the literature regarding their management. Making the decision to observe or perform surgery is thus not an easy task. New, promising therapeutic methods involving ablation under endoscopic ultrasound (EUS) guidance with ethanol or radiofrequency ablation have been applied for these lesions with good clinical outcomes but only with short-term follow-up data. In this review, we address the emerging question of when to follow-up and when to perform surgery for small asymptomatic pancreatic tumours, with consideration of the potential of ablative therapies.
Keyphrases
- minimally invasive
- coronary artery bypass
- radiofrequency ablation
- squamous cell carcinoma
- surgical site infection
- small cell lung cancer
- signaling pathway
- systematic review
- magnetic resonance imaging
- oxidative stress
- computed tomography
- percutaneous coronary intervention
- climate change
- big data
- toll like receptor
- electronic health record
- atrial fibrillation
- data analysis
- fine needle aspiration