ANALYSIS OF OUTCOMES SURGICAL TREATMENT OF PATIENTS WITH NEUROENDOCRINE TUMORS

Abstract

The aim of the study: evaluate the possibility of surgical method in the treatment of patients with neuroendocrine tumors of the gastrointestinal tract and pancreas. Materials and methods. The results of treatment of 283 patients with neuroendocrine tumors of the gastrointestinal tract (GI NET) and pancreas (PNET) were studied. Women were 60.8 %, the average age - 55.8 years. Examination of patients was carried out using laboratory (chromogranin-A, serotonin, 5-GIUK, insulin, gastrin), instrumental (ultrasound, CT, MRI, EGD, FCS, PET 68Ga-DOTATOC) and morphological (histology, immunohistochemistry) diagnostic methods. Results. Surgical treatment was performed in 233 (82.3 %) cases. Endoscopic tumor removal was performed in 56.7% of patients with localized GI NET. Postoperative complications in localized and locally advanced GI NET developed in 8.1 % and 9.5% of cases. Patients localized PNET enucleation was performed in 54.7 % of cases, median resection - 3.1 %, head resection - 4.7%, distal resection - 26.6%, pancreatoduodenal resection (PD) - 10.9 %. In cases of locally advanced PNET surgical treatment was performed distal resection in 58.3 % of patients, PD - 16.7 %, head resection - 25 %. There were no significant differences in the frequency of postoperative complications in patients with localized (37.9 %) and locally advanced (41.7 %) PNET (p 0.05). In generalized NET cytoreduction was performed in 13.7 % of patients, removal of the primary tumor - 32.6 %. Median survival of patients after cytoreduction, primary tumor removal, drug therapy in an isolated version was 43.4 months., 38.9 months. and 24 months. (p 0.05). The 5-year survival rate of patients with localized NET was 81.9%, locally advanced - 57.1%, generalized - 27.6%. Conclusion. The surgical method is the main in the treatment of patients with localized and locally advanced NET. In cases of generalized NET, multidisciplinary assessment of the possibility of surgical treatment of patients is necessary in all cases.