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Small Intestinal Ne...
Small Intestinal Neuroendocrine Tumor : A Rare Malignancy with Favorable Outcome
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- Norlén, Olov (author)
- Uppsala universitet,Endokrinkirurgi
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- Stålberg, Peter, Docent (thesis advisor)
- Uppsala universitet,Endokrinkirurgi
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- Hellman, Per, Professor (thesis advisor)
- Uppsala universitet,Endokrinkirurgi
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- Björklund, Peyman, Ph.D. (thesis advisor)
- Uppsala universitet,Endokrinkirurgi
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- Sundin, Anders, Professor (thesis advisor)
- Department of Radiology, Karolinska University Hospital, Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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- Naredi, Peter, Professor (opponent)
- Gothenburg University, Sahlgrenska University Hospital, Department of surgery
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(creator_code:org_t)
- ISBN 9789155485481
- Uppsala : Acta Universitatis Upsaliensis, 2013
- English 78 s.
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Series: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 844
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Abstract
Subject headings
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- Small intestinal neuroendocrine tumor (SI-NET) is the most common small bowel tumor in Europe and USA, with an annual incidence of around 0.3-1.3/100000 persons. SI-NETs are the most common type of gastroenteropancreatic NETs (GEP-NETs), and they are known for their ability to produce hormones such as tachykinins and serotonin, as well as for their favorable long-term prognosis in comparison to gastrointestinal adenocarcinoma. The overall aim of the thesis was to investigate unknown or unclear aspects of SI-NET disease, in connection with prognosis, treatment and follow-up. Paper I confirmed several known negative prognostic factors and also showed, for the first time, that para-aortal lymph node metastases and peritoneal carcinomatosis were associated with worse survival by multivariable analyses. Locoregional surgery was associated with a low post-operative mortality, and a prolonged long-term survival by multivariable analysis. In Paper II we continued to investigate peritoneal carcinomatosis and found it be a risk factor not only for death, but also for emergency re-surgery. Furthermore, genetic analyses of samples from primary tumors in patients with and without peritoneal carcinomatosis showed a difference in the DNA between these two groups. In Paper III the outcome after liver surgery and/or radiofrequency ablation of liver metastases was investigated. To summarize, no difference in survival was seen in patients treated with surgery/radiofrequency ablation in comparison with matched controls. However, a superior radiological response of liver metasases and lower U-5-HIAA values were seen in patients subjected to liver surgery and/or radiofrequency ablation compared to matched controls. Paper IV compared ultrasonography, computed tomography and 11C-5HTP-PET in the follow-up after radiofrequency ablation of NET liver metastases. The study concluded that 11C-5HTP-PET depicted all residual tumors after RFA and that it, if used, should be combined with computed tomography for easier interpretation, as RFA areas are not clearly distinguishable with 11C-5HTP-PET alone. Paper V studied gallstone complications after somatostatin analog treatment in SI-NET patients, and concluded that there was a rather high risk to be subjected to a cholecystectomy due to biliary colic, cholecystitis, cholangitis or pancreatitis after primary surgery in somatostatin analog treated patients.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Neuroendocrine tumor
- peritoneal carcinomatosis
- single nucleotide polymorphism array
- liver metastases
- radiofrequency ablation
- liver surgery
- positron emission tomography
- somatostatin analogs
- cholecystectomy
- Kirurgi
- Surgery
Publication and Content Type
- vet (subject category)
- dok (subject category)
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Norlén, Olov
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Stålberg, Peter, ...
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Hellman, Per, Pr ...
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Björklund, Peyma ...
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Sundin, Anders, ...
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Naredi, Peter, P ...
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MEDICAL AND HEAL ...
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and Surgery
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Uppsala University