Tratamiento quirúrgico de los tumores neuroendocrinos gastroenteropancreáticos

Surgery is the cornerstone of the treatment of gastroenteropancreatic tumors. These neoplasms usually have a good prognosis. Endocrine symptoms are often the only problem noticed by the patient and these can be treated pharmacologically. Surgical indication must be considered carefully, as this type of therapy may be too aggressive for benign tumors; on the other hand, the only chance for cure is tumoral resection. Surgery is not contraindicated in cases of distant metastases, as both cytoreductive surgery and metastases resection are associated with an increase in symptom-free survival and, in the latter, to overall survival and sometimes curation. Liver transplantation is controversial; although it can increase survival, its usefulness is limited by the shortage of donors and by carcinogenesis secondary to immunosuppression. Recently, new ablative techniques have been introduced, such as radiofrequency ablation or cryotherapy, both of which achieve good results mainly in the treatment of metastatic disease.