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The Scientific World Journal
Volume 2012, Article ID 357475, 9 pages
Review Article

Surgical Treatment of Sporadic Pancreatic Neuroendocrine Tumors: A State of the Art Review

1Department of Hepato-Pancreato-Biliary Surgery, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
2Institute of Clinical Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway
3Interventional Centre, Rikshospitalet, Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway

Received 12 October 2012; Accepted 25 November 2012

Academic Editors: Y. Motoo and P. Zezos

Copyright © 2012 Sven-Petter Haugvik et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Pancreatic neuroendocrine tumors (PNETs) are rare neoplasms. They are clinically diverse and divided into functioning and nonfunctioning disease, depending on their ability to produce symptoms due to hormone production. Surgical resection is the only curative treatment and remains the cornerstone therapy for this patient group, even in patients with advanced disease. Over the last decade there has been a noticeable trend towards more aggressive surgery as well as more minimally invasive surgery in patients with PNETs. This has resulted in improved long-term survival in patients with locally advanced and metastatic disease treated aggressively, as well as shorter hospital stays and comparable long-term outcomes in patients with limited disease treated minimally invasively. There are still controversies related to issues of surgical treatment of PNETs, such as to what extent enucleation, lymph node sampling, and vascular reconstruction are beneficial for the oncologic outcome. Histopathologic tumor classification is of high clinical importance for treatment planning and prognostic evaluation of patients with PNETs. A constant challenge, which relates to the treatment of PNETs, is the lack of an internationally accepted histopathological classification system. This paper reviews current issues on the surgical treatment of sporadic PNETs with specific focus on surgical approaches and tumor classification.