Surgical Strategy For Nonfunctioning Islet Cell Tumors: Experiences And Perspectives

Objective:To summarize the experiences of surgical treatment of non-functioning islet cell tumors(NITs)and explore the appropriate surgical strategy.Method:The clinical data and follow up of 79 patients with NITs were retrospectively analyzed. T₅₀was different in the radical surgery team and palliative treatment team.Results: The sensitivities of tumor localization with preoperative ultrasonography(US)and computed tomography(CT)were 79.7%and 88.1%,respectively.66 patients with NITs underwent radical resections,including pancreaticoduodenectomy in 20cases, resection of distal pancreas in 33 cases,enucleation of tumor in 13 cases.Otherwise, Partial resection of the head of the pancreas in 3 cases and palliative shunt operation in 4 cases.Biopsy in 4 cases,1 patient received chemotherapy and 1 patient have not received any therapy.The overall resection rate is 83.5%with postoperative complications of transient pancreatic leakages in 10 cases and subdiaphragmic abscess in 3 cases.70 patients' Mean follow-up was5.3±3.6 years(range,3 months to 16 years),9 patients were missed,the missing rate was 11.4%. The overall(70 patients)mediam survival time(T₅₀)was 10.9 years,T₅₀ was 14.7 years in the radical surgery team,which was 3.1 years in the palliative treatment team.The 1- and 3- year survival rate were 97.3 %and 90.1%for all the patients,respectively.Conclusion:The preoperative topographic diagnosis for NITs can be achieved by application of combination of US and CT.An aggressive surgical approach seems to be primarily indicated for NITs to received a long life expectancy. Surgical method depends on the characteristics of NITs,the anatomic relationship to neighboring structures and the existence of metastasis.