Role of surgical treatments in high-grade or advanced gastroenteropancreatic neuroendocrine neoplasms

doi:10.4240/wjgs.v14.i5.397

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World Journal of Gastrointestinal Surgery

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World J Gastrointest Surg. May 27, 2022; 14(5): 397-408
Published online May 27, 2022. doi: 10.4240/wjgs.v14.i5.397

Role of surgical treatments in high-grade or advanced gastroenteropancreatic neuroendocrine neoplasms

Qing-Yang Que, Lin-Cheng Zhang, Jia-Qi Bao, Sun-Bin Ling, Xiao Xu

Qing-Yang Que, Lin-Cheng Zhang, Jia-Qi Bao, Sun-Bin Ling, Xiao Xu, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Hangzhou 310006, Zhejiang Province, China

Qing-Yang Que, Lin-Cheng Zhang, Jia-Qi Bao, Sun-Bin Ling, Xiao Xu, Zhejiang University Cancer Center, Hangzhou 310006, Zhejiang Province, China

Qing-Yang Que, Lin-Cheng Zhang, Jia-Qi Bao, Sun-Bin Ling, Xiao Xu, NHC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou 310006, Zhejiang Province, China

Qing-Yang Que, Lin-Cheng Zhang, Jia-Qi Bao, Sun-Bin Ling, Xiao Xu, Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China

Xiao Xu, Institute of Organ Transplantation, Zhejiang University, Hangzhou 310003, Zhejiang Province, China

Author contributions: Que QY, Ling SB, and Xu X formulated the research goals and aims; Que QY, Bao JQ, Zhang LC, Ling SB, and Xu X performed the research; Que QY, Bao JQ, and Zhang LC wrote the manuscript; All authors have read and approve the final manuscript.

Supported by State Key Program of National Natural Science Foundation of China, No. 81930016; Zhejiang Provincial Natural Science Foundation of China, No. LY21H160026.

Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Corresponding author: Xiao Xu, FACS, MD, PhD, Academic Fellow, Chief Doctor, Professor, Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. zjxu@zju.edu.cn

Received: October 25, 2021
Peer-review started: October 25, 2021
First decision: December 27, 2021
Revised: January 19, 2022
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: May 27, 2022
Processing time: 211 Days and 17.3 Hours

Core Tip

Core Tip: Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) encompass a heterogeneous group of tumors with unique indolent biological behavior. The role of surgery in high-grade or advanced GEP-NENs is still controversial. There are several highlights of this review. First, we address the surgical benefits of selected high-grade GEP-NENs and summarize the tumor biological markers correlated with a prognosis. Second, we review various surgical strategies, including curative resection, debulking, resection after neoadjuvant therapy for metastatic GEP-NENs, and the latest clinical evidence. Finally, liver transplantation presents a curative therapeutic option for GEP-NEN patients with liver metastasis. We summarize the new findings and propose directions for future development.