Strategy for pancreatic endocrine tumors

Background/Aims: The endocrine tumors of the pancreas are rare diseases and there is no established standard therapy for the liver metastasis of pancr eatic endocrine tumors. In this study, the therapy for the pancreatic endoc rine tumors was evaluated. Methodology: The endocrine pancreas tumors of 13 patients had been surgical ly treated. All primary tumors were completely resected. The liver metastas is was recognized in 4 patients. Partial resection of the liver was perform ed in 2 patients. Lipiodoltranscatheter arterial embolization was performed for synchronous unresectable liver metastases in the other 2 patients. Results: The patients with no liver metastases survived without recurrence (max: 18.8yr; mean follow-up: 9.2yr). The patient with resected synchronous solitary liver metastasis died of recurrent multiple liver metastases 5 mo nths after surgery. The other patient with the metachronous liver metastasi s completely resected survived 13.9 years. In the 2 patients with unresecta ble numerous liver metastases, after lipiodol-transcatheter arterial emboli zation, tumor necrosis rate was more than 90% in both cases and serum gastr in level was normalized. Conclusions: Complete resection of liver metastasis is favorable, whereas l ipiodol-transcatheter arterial embolization is effective for unresectable l iver metastases from pancreatic endocrine tumors as palliation. Complete re section of the primary site is recommended even in the cases with unresecta ble numerous liver metastases.