Published online Aug 27, 2014. doi: 10.4254/wjh.v6.i8.596
Revised: June 25, 2014
Accepted: July 15, 2014
Published online: August 27, 2014
Processing time: 132 Days and 15.7 Hours
Pancreatic neuroendocrine tumor (P-NET) is rare and slow-growing. Current classifications predict its prognosis and postoperative recurrence. Curative resection is ideal, although often difficult, because over 80% of patients have unresectable multiple liver metastases and extrahepatic metastasis. Aggressive surgery for liver metastases is important to improve survival. Aggressive or cytoreductive surgery for liver metastases is indicated to reduce hormone levels and improve symptoms and prognosis. Liver transplantation was originally conceived as an ideal therapy for unresectable liver metastases. Unfortunately, there is no clear consensus on the role and timing of surgery for primary tumor and liver metastases. Surgeons still face questions in deciding the best surgical scenario in patients with P-NET with unresectable liver metastases.
Core tip: Pancreatic neuroendocrine tumor is rare. Current classifications predict its prognosis and postoperative recurrence. Curative resection is often difficult, because over 80% of patients have unresectable multiple liver metastases and extrahepatic metastasis. Aggressive or cytoreductive surgery for liver metastases is indicated to reduce hormone levels and improve symptoms and prognosis. Liver transplantation was originally conceived as an ideal therapy for unresectable liver metastases. However, there is no clear consensus on the role and timing of surgery for primary tumor and liver metastases.