Treatment Options and Risk Factors of Pancreatic Neuroendocrine Neoplasms

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 1197

Special Issue Editors


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Guest Editor
Pancreatic and Endocrine Digestive Surgical Unit, Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Via Giustiniani 2, 35128 Padova, Italy
Interests: pancreas; pancreatic surgery; pancreatic cancer; neuroendocrine neoplasm

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Guest Editor
Pancreatic and Endocrine Digestive Surgical Unit, Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Via Giustiniani 2, 35128 Padova, Italy
Interests: gastrointestinal hormones; role of tumor markers in exocrine and endocrine pancreatic neoplasms; pancreatic surgery; neuroendocrine tumors

Special Issue Information

Dear Colleagues,

Pancreatic neuroendocrine neoplasms (Pan-NENs) are considered rare tumors with a wide spectrum of hormonal secretion, or if “inactive” may have indolent behavior, largely dependent on the tumor extension, grading, inherited presence of gene mutations, expression of somatostatin receptors, and other factors that may influence the indication and results of the treatment options.

Despite technical improvements, the diagnosis, localization, and staging of the Pan-NEN are not easy to assess, and the timing and sequencing of different treatment options is still debated and under evaluation.

Different therapeutic options (surgery, loco-regional ablation, trans-arterial embolization, ultrasound-guided radiofrequency ablation, target therapy, chemo- and radioligand therapy) may result in different responses in Pan-NEN  with apparently similar TNM stages. The assessment of therapeutic response is also difficult to evaluate in these patients, who very often show good performance statuses even with advanced and extended disease.

In this context, we must understand the likelihood, benefits, and costs of the different procedures and the results of integrated multimodal procedures to offer the best Pan-NEN management strategy with less risk. This Special Issue will highlight the main strengths and limitations of the management of Pan-NENs, ranging from the diagnosis to the response to therapy, and investigate the emerging role of new therapeutic approaches.

Prof. Dr. Anna Caterina Milanetto
Prof. Dr. Claudio Pasquali
Guest Editors

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Keywords

  • pancreatic neuroendocrine neoplasms
  • CT scan
  • MRI
  • PET/CT
  • target therapy
  • radioligand therapy
  • chemotherapy
  • microwave ablation
  • radiofrequency ultrasound ablation
  • hepatic arterial embolization

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Published Papers (1 paper)

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Research

14 pages, 2960 KiB  
Article
Trans-Arterial Embolization for Liver Metastases of Gastroenteropancreatic Neuroendocrine Tumors: Response Indicates Survival Benefit?
by Luohai Chen, Dequan Yang, Yueriguli Yusufu, Haikuan Liu, Man Liu, Yuan Lin, Yanji Luo, Qiao He, Minhu Chen, Zhirong Zeng, Ning Zhang and Yu Wang
Cancers 2025, 17(2), 309; https://doi.org/10.3390/cancers17020309 - 19 Jan 2025
Viewed by 876
Abstract
Objective: To determine the impact of trans-arterial embolization (TAE) on overall survival (OS) in patients with liver metastases from gastroenteropancreatic neuroendocrine tumors (LM-GEP-NETs) and to identify factors that may influence tumor response to TAE treatment. Methods: This study included patients with histologically and [...] Read more.
Objective: To determine the impact of trans-arterial embolization (TAE) on overall survival (OS) in patients with liver metastases from gastroenteropancreatic neuroendocrine tumors (LM-GEP-NETs) and to identify factors that may influence tumor response to TAE treatment. Methods: This study included patients with histologically and radiologically confirmed LM-GEP-NETs who received TAE treatment at The First Affiliated Hospital, Sun Yat-sen University, between November 2016 and January 2023. Imaging responses were assessed using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST) criteria. Tumor response was defined as complete or partial remission. Results: In total, 267 patients with LM-GEP-NETs were included. Patients with liver tumor burdens <25%, 25–50%, and ≥50% had progressively worse OS (p < 0.005). According to the RECIST criteria, 65.9% of patients exhibited tumor responses. Using the mRECIST criteria, 77.5% of patients showed tumor responses. Survival analyses with log-rank tests indicated that patients with tumor responses assessed using either the RECIST or mRECIST criteria had significantly better OS (p = 0.015 and p = 0.023, respectively). Further logistic regression analyses showed that early TAE (within 4 months after diagnosis of liver metastases) was associated with tumor responses assessed using RECIST or mRECIST. These results were further verified using propensity score matching and inverse probability treatment weighting adjusted datasets. Conclusions: A higher liver tumor burden was associated with poorer OS in patients with LM-GEP-NETs. Tumor response after TAE indicates survival benefits. Early TAE (within 4 months of diagnosis) was associated with better treatment responses. Full article
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