CAJ | 학술논문

20％～ 30％胰腺神经内分泌肿瘤(pNENs)在初诊时可切除,70％～ 80％的pNENs是局部晚期或转移性肿瘤.对手术可切除的pNENs,建议积极手术切除原发肿瘤和转移肿瘤.对功能性的局部晚期或转移性pNENs,积极的减瘤术有助于控制症状,改善患者的生命质量;无功能性肿瘤不推荐减瘤术,除非发生出血、梗阻等危及生命的并发症.对Ⅰ型肝转移,应积极联合原发肿瘤切除;Ⅱ型肝转移,可探索全身综合治疗联合肝脏的局部治疗,如RFA、动脉栓塞和栓塞化疗;Ⅲ型肝转移可给予舒尼替尼、依维莫斯联合长效生长抑素的治疗.pNENs获得根治性切除后无需辅助治疗,但若是转移性病灶获得根治性切除,建议给予后续治疗,预防复发.
20％～ 30％이선신경내분비종류(pNENs)재초진시가절제,70％～ 80％적pNENs시국부만기혹전이성종류.대수술가절제적pNENs,건의적겁수술절제원발종류화전이종류.대공능성적국부만기혹전이성pNENs,적겁적감류술유조우공제증상,개선환자적생명질량;무공능성종류불추천감류술,제비발생출혈、경조등위급생명적병발증.대Ⅰ형간전이,응적겁연합원발종류절제;Ⅱ형간전이,가탐색전신종합치료연합간장적국부치료,여RFA、동맥전새화전새화료;Ⅲ형간전이가급여서니체니、의유막사연합장효생장억소적치료.pNENs획득근치성절제후무수보조치료,단약시전이성병조획득근치성절제,건의급여후속치료,예방복발.
About 20％-30％ of pancreatic neuroendocrine neoplasms (pNENs) are resectable after the initial diagnosis,and about 70％-80％ of pNENs are locally advanced or metastatic tumors.For resectable pNENs,primary and metastatic lesions are suggested to be resected,and for locally advanced or metastatic functional tumors,debulking surgery is encouraged for controlling the symptoms and alleviating the life quality; debulking surgery could not improve the overall survival of patients with non-functional neuroendocrine tumors,unless there are lifethreatening complications such as bleeding or obstruction.For type Ⅰ liver metastasis,simultaneous resection of primary and metastatic lesions is advised; while for type Ⅱ liver metastasis,systemic treatment combined with local treatment (radio-frequency ablation,transcatheter arterial chemoembolization and transartery embolization) is effective; for type Ⅲ liver metastasis,target therapy such as Sunitinib,Everolimus combined with long acting Sandostatin is effective.No adjuvant therapy is needed after radical resection of pNENs,while following therapy is suggested for patients after metastatic pNENs resection.