臨床外科70巻4号

2015年04月発行

特集 膵・消化管神経内分泌腫瘍（GEP-NET）のアップデート

GE-NETの治療方針

著者： 林義人¹ 井上拓也¹ 辻井正彦¹ 竹原徹郎¹

所属機関： ¹大阪大学大学院医学系研究科消化器内科学

ページ範囲：P.438 - P.442

【ポイント】
◆内視鏡治療は，リンパ節転移の確率が低いと考えられる径10 mm以下のGE-NETに対して適応となる．
◆GE-NETに対する治療法は，基本的に手術療法が推奨される．
◆薬物療法は，細胞学的悪性度を考慮して治療法を選択する必要がある．

参考文献

1）Ito T, Tanaka M, Sasano H, et al：Preliminary results of a Japanese nationwide survey of neuroendocrine gastrointestinal tumors. J Gastroenterol 42：497-500, 2007

2）Rindi G, Klöppel G, Alhman H, et al：and all other Frascati Consensus Fonference participants；European Neuroendocrine Tumor Society（ENETS）：TNM staging of foregut（neuro）endocrine tumors：a consensus proposal including a grading system. Virchows Arch 449：395-401, 2006

3）Rindi G, Klöppel G, Couvelard A, et al：TNM staging of midgut and hindgut（neuro）endocrine tumors：consensus proposal including a grading system. Virochows Arch 451：757-762, 2007

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

5）Klöppel G, Couvelard A, Perren A, et al；Malloca Consensus Conference participants；European Neroendocrine Tumor Society：ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors：towards a standardized approach to the diagnosis of gastroenteropancreatic neuroendocrine tumors and their prognostic stratification. Neuroendocrinology 90：162-166, 2009

6）Park HW, Byeon JS, Park YS, et al：Endoscopic submucosal dissection for treatment of rectal carcinoid tumors. Gastrointest Endosc 72：143-149, 2010

7）Lee DS1, Jeon SW, Park SY, et al：The feasibility of endoscopic submucosal dissection for rectal carcinoid tumors：comparison with endoscopic mucosal resection. Endoscopy 42：647-651, 2010

8）Zhou PH, Yao LQ, Qin XY, et al：Advantages of endoscopic submucosal dissection with needle-knife over endoscopic mucosal resection for small rectal carcinoid tumors：a retrospective study. Surg Endosc 24：2607-2612, 2010

9）Onozato Y, Kakizaki S, Iizuka H, et al：Endoscopic treatment of rectal carcinoid tumors. Dis Colon Rectum 53：169-176, 2010

10）斎藤祐輔，岩下明徳，飯田三雄：大腸カルチノイド腫瘍の全国集計．胃と腸40：200-213, 2005

11）Konishi T, Watanabe T, Kishimoto J, et al：Prognosis and risk factors of metastasis in colorectal carcinoids：results of a nationwide registry over 15 years. Gut 56：863-868, 2007

12）Steinmuller T, Kianmanesh R, Falconi M, et al：Conesensus guidelines for the management of patients with liver metastases from digestive（neuro）endocrine tumors：forgut, midgut, hindgut, and unknown primary. Neuroendocrinology 87：47-62, 2008

13）Sarmiento JM, Heywood G, Rubin J, et al：Surgical treatment of neuroendocrine metastases to the live：a plea for resection to increase survival. J Am Coll Surg 197：29-37, 2003

14）Chamberlain R, Canes D, Brown K, et al：Hepatic neuroendocrine metastases：does intervention alter outcomes? J Am Coll Surg 190：432-445, 2000

15）Chen H, Hardacre J, Uzar A, et al：Isolated liver metastases from neuroendocrine tumors：dose resection prolong survival? J Am Coll Surg 187：88-92, 1998

16）Mayo SC, de Jong MC, Pulitano C, et al：Surgical management of hepatic neuroendocrine tumor metastasis：results from an international multi-institutional analysis. Ann Sur Oncol 17：3129-3136, 2010

17）Vogl TJ, Naguib NN, Zangos S, et al：Liver metastasis of neuroendocrine carcinomas：interventional treatment via transarterial emboloization, chemoembolization and thermal ablation. Eur J Radiol 72：517-528, 2009

18）Mazzaglia PJ, Berber E, Milas M, et al：Laparoscopic radiofrequency ablation of neuroendocrine liver metastases：a 10-year experience evaluating predictors of survival. Surgery 142：10-19, 2007