COMBINED TREATMENT OF PATIENTS WITH PANCREATIC NEUROENDOCRINE CARCINOMAS

Aim. To analyze the results of treatment of patients with pancreatic  malignant neuroendocrine tumors.

Materials and Methods. Since 2005 to 2014 period 49 patients with malignant neuroendocrine tumors were examined and treated.  76.6% patients  (n = 38) were treated  within 2010–2014  years. In 59.2% of cases liver metastatic  lesion occured.  Comprehensive  specific treatment with surgical resection  of primary tumor  site was used in 73.5% of cases (n  = 36).  Some  patients  received  perioperative  intraarterial   chemoembolization and  surgical  tumor  removal  was supplemented  by radiofrequency or microvave ablation of metastatic liver sites, anatomical  liver resections.

Results. Postoperative mortality was observed only after extended surgical resection (8.3%, (n = 3)). All patients with low differentiated tumors had histological signs of perineural invasion, abcence of therapeutical effect of specific treatment even after surgical resection of primary tumor site. In view of this long-term  survival was low. At present time most of surgically treated patients (85.2%, (n = 32)) with low and moderately differentiated neuroendocrine tumors live without signs of progression. Follow-up varies within 5–119 months.

Conclusion. Combined  treatment including aggressive surgical approach  and perioperative  intraarterial  chemoembolization is associated with good remote results in case of highly and moderately differentiated neuroendocrine tumors.

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