OBJECTIVE: To evaluate surgical strategies for neuroendocrine @entity788 (NEPT) in the light of the new WHO classification from 2004 and to draw conclusions for future surgical concepts. BACKGROUND: : The extent of surgical resection in primary and recurrent NEPT is unclear. METHODS: Between 1987 and 2004, 62 @entity1 with sporadic NEPT were treated at our institution and sections from biopsy and resection specimen were histopathologically reclassified. Clinical presentation, surgery, metastases, and pattern of recurrence were related to survival. RESULTS: Fifteen @entity5 ( @entity5 , 24%), 39 @entity189 ( @entity189 , 63%), and 8 high-grade @entity189 (HGC, 13%) were identified. Median observation time was 30.5 months; 48 of 62 @entity1 (78%) were surgically resected, and in 45 @entity1 R0/R1 status was achieved. Overall 2- and 5-year survival in the latter group was 80% and 64%, respectively. Retrospective WHO classification revealed that organ-preserving segmental resections had been performed in 10 @entity189 and 1 HGC. These @entity1 showed equal outcome as radically resected counterparts (n = 19). Liver and other organ metastases were present in 19 of 62 @entity1 (31%), and resection was accomplished in 7 of 19 @entity1 , which conferred better overall survival (P = 0.026, log-rank test); 21 of 45 R0/R1-resected @entity1 (47%) suffered from recurrence, and reoperation was accomplished in 9 @entity1 , which resulted in better overall survival (P = 0.066). CONCLUSION: Organ-preserving resections offer sufficient local control in @entity189 ; therefore, radical resections do not seem to be justified. On the other hand, radical resection is indicated even in metastasized @entity1 or in case of loco-regional recurrence. The silent and slow course of the disease facilitates long-term surgical control.

Aggressive surgery improves long-term survival in neuroendocrine XXXX : an institutional experience.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatic tumors'] @entity189 :: ('MESH:D002277', 'Disease') :: ['LGC', 'low-grade carcinomas', 'carcinomas'] @entity5 :: ('MESH:D009369', 'Disease') :: ['well-differentiated tumors', 'WDT']
@entity788 :: (MESH:D010190,Disease) :: ['pancreatic tumors']
