Ramazan GÜNDOĞDU, Serkan ERKAN, Hakan YABANOĞLU, M. Eda ERTÖRER, Esra Zeynep COŞKUNOĞLU, Fatma ÖZARSLAN

Pankreas Nöroendokrin Tümörlerinin Cerrahi Tedavisinde 11 Yıllık Tek Merkez Deneyimi

Giriş: Pankreatik nöroendokrin tümörler (pNET) nadir görülen hastalıklardır ve cerrahi ön planlı tedavi yüz güldürücüdür. Bu çalışmada hastanemizde son 11 yılda pankreatik nöroendokrin tümör nedeniyle cerrahi tedavi uygulanmış hastaları geriye dönük inceleyerek; bulgularımızı literatüre sunmayı amaçladık. Materyal Metod: Ocak 2011 ile Mart 2022 tarihleri arasında pNET nedeniyle başvuran hastaların dosyaları geriye dönük incelendi. Çoklu veri eksiği olan, operasyon yapılmamış ve 18 yaşından küçük olan hastalar çalışma dışı bırakıldı. Hastalar yaş, cinsiyet, operasyon türü, tümör boyutu, tipi ve histolojik özellikleri, hastanede kalış, nüks hastalık ve sağ kalım açısından değerlendirildi. Bulgular: Çalışmaya alınan 33 hastanın 13’ü kadın 20’si erkektı ve yaş ortanca değeri 56 (18-86) idi. Fonksiyonel tümörü olan 8 hasta vardı ve biri somatostatinoma olup diğerleri insülinomaydı. Hastaların 7’sine enükleasyon; 26’sına pankreatektomi yapıldı. Ana lezyonu adenokanser ve seröz kistadenom olup rezeksiyon uygulanan ve spesmen patolojisinde insidental pNET saptanan üç hasta vardı. Tümörü grade 1, 2 ve 3 olan sırasıyla 23, 7 ve 3 hastamız vardı. Tümör çapı ortanca değeri 24 (3-80) mm idi. Hastanede yatış süresi ortanca değeri 7 (2-50) gündü. Takip süresi ortanca değeri 24 (1-71) ay; hastalıksız sağ kalım 14 (1-71) aydı. Tartışma ve Sonuç: pNET’ler nadir görülen ve insidental olarak da saptanabilen, titizlikle yönetilmesi gereken hastalıklardır. pNET’in cerrahi ve konservatif tedavisinde fikir birliği sağlanabilmesi için daha geniş serileri içeren çalışmalar yapılması gerekmektedir.

Anahtar Kelimeler:

nöroendokrin tümör, pankreas, insülinoma, enükleasyon

11-Year Single Center Experience in The Surgical Treatment of Pancreatic Neuroendocrine Tumors

Background: Pancreatic neuroendocrine tumors (pNET) are rare diseases and surgical treatment is promi-sing. In this study, we retrospectively analyzed the patients who underwent surgical treatment for pancrea-tic neuroendocrine tumor in our hospital in the last 11 years; We aimed to present our findings to the litera-ture.Materials and Methods: The files of the patients who applied for pNET between January 2011 and March 2022 were retrospectively analyzed. Patients with multiple data deficiencies, who did not undergo surgery, and who were younger than 18 years of age were excluded from the study. The patients were evaluated in terms of age, gender, type of operation, tumor size, type and histological features, hospital stay, recurrent disease and survival.Results: Of the 33 patients included in the study, 13 were female and 20 were male, and the median age was 56 (18-86). There were 8 patients with functional tumors, one was somatostatinoma and the others were insulinomas. Enucleation in 7 of the patients; Pancreatectomy was performed in 26 of them. There were three patients whose main lesion was adenocarcinoma and serous cystadenoma, who underwent resection and whose specimen pathology had incidental pNET. We had 23, 7 and 3 patients with grade 1,2 and 3 tumors, respectively. The median value of tumor diameter was 24 (3-80) mm. The median value for hospital stay was 7 (2-50) days. The median value of follow-up was 24 (1-71) months; disease-free survival was 14 (1-71) months.Conclusions: pNETs are a rare disease that can be detected incidentally and should be carefully managed. Studies with larger series are needed to reach a consensus on the surgical and conservative treatment of pNET.Keywords: Neuroendocrine tumor, Pancreas, Insulinoma, Enucleation

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