臨床外科67巻11号

2012年10月発行

特集 外科医のための癌診療データ 臓器別最新データ 11．膵・消化管神経内分泌腫瘍（NET）

膵・消化管NETの治療

著者： 土井隆一郎¹

所属機関： ¹大津赤十字病院外科

ページ範囲：P.301 - P.306

覚えておきたいデータ

◆胃NETで1cm以上，sm浸潤を伴うものは，D2郭清を伴う幽門側胃切除術あるいは胃全摘術の適応である．

◆直腸NETで2cmを超えるもの，または1～2cmで固有筋層浸潤，脈管侵襲，局所リンパ節転移の疑いがあるものは手術切除の適応である．

◆膵NET（G1/G2）に対するエベロリムス，スニチニブの有効性が示されており，無増悪生存期間の中央値は11か月である．

参考文献

1）Rindi G, Luinetti O, Cornaggia M, et al：Three subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma：a clinicopathologic study. Gastroenterology 104：994-1006, 1993

2）Ichikawa J, Tanabe S, Koizumi W, et al：Endoscopic mucosal resection in the management of gastric carcinoid tumors. Endoscopy 35：203-206, 2003

3）Akerström G, Hellman P：Surgery on neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab 21：87-109, 2007

4）Kulke MH, Anthony LB, Bushnell DL, et al：NANETS treatment guidelines：well-differentiated neuroendocrine tumors of the stomach and pancreas. Pancreas 39：735-752, 2010

5）Ruszniewski P, Delle Fave G, Cadiot G, et al：Well-differentiated gastric tumors/carcinomas. Neuroendocrinology 84：158-164, 2007

6）Mullen JT, Wang H, Yao JC, et al：Carcinoid tumors of the duodenum. Surgery 138：971-977, 2005

7）Soga J：Early-stage carcinoids of the gastrointestinal tract：an analysis of 1914 reported cases. Cancer 103：1587-1595, 2005

8）Ito T, Sasano H, Tanaka M, et al：Epidemiological study of gastroenteropancreatic neuroendocrine tumors in Japan. J Gastroenterol 45：234-243, 2010

9）Yao JC, Hassan M, Phan A, et al. One hundred years after“carcinoid”：epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 26：3063-3072, 2008

10）Metz DC, Jensen RT：Gastrointestinal neuroendocrine tumors：pancreatic endocrine tumors. Gastroenterology 135：1469-1492, 2008

11）Fernandez-Cruz L, Blanco L, Cosa R, et al：Is laparoscopic resection adequate in patients with neuroendocrine pancreatic tumors? World J Surg 32：904-917, 2008

12）Anlauf M, Garbrecht N, Henopp T, et al：Sporadic versus hereditary gastrinomas of the duodenum and pancreas：distinct clinicopathological and epidemiological features. World J Gastroenterol 12：5440-5446, 2006

13）Morrow EH, Norton JA：Surgical management of Zollinger-Ellison syndrome；state of the art. Surg Clin North Am 89：1091-1103, 2009

14）Kindmark H, Sundin A, Granberg D, et al：Endocrine pancreatic tumors with glucagon hypersecretion：a retrospective study of 23 cases during 20 years. Med Oncol 24：330-337, 2007

15）Bettini R, Partelli S, Boninsegna L, et al：Tumor size correlates with malignancy in nonfunctioning pancreatic endocrine tumor. Surgery 150：75-82, 2011

16）Rinke A, Müller HH, Schade-Brittinger C, et al：Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors：a report from the PROMID Study Group. J Clin Oncol 27：4656-4663, 2009

17）Sun W, Lipsitz S, Catalano P, et al：Phase Ⅱ/Ⅲ study of doxorubicin with fluorouracil compared with streptozocin with fluorouracil or dacarbazine in the treatment of advanced carcinoid tumors：Eastern Cooperative Oncology Group Study E1281. J Clin Oncol 23：4897-4904, 2005

18）Hainsworth JD, Spigel DR, Litchy S, et al：Phase Ⅱ trial of paclitaxel, carboplatin, and etoposide in advanced poorly differentiated neuroendocrine carcinoma：a Minnie Pearl Cancer Research Network Study. J Clin Oncol 24：3548-3554, 2006

19）Yao JC, Shah MH, Ito T, et al：Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med 364：514-523, 2011

20）Raymond E, Dahan L, Raoul JL, et al：Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med 364：501-513, 2011