| Achieving eugastrinemia in MEN1 patients: both duodenal inspection and formal lymph node dissection are important. | |
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MedLine Citation:
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PMID: 22136834 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Controversy exists regarding the role and extent of operation for patients with multiple endocrine neoplasia type 1 (MEN1) and hypergastrinemia. METHODS: An institutional MEN1 database was reviewed to identify patients with evidence of hypergastrinemia. The relationship of extent of resection to achievement of eugastrinemia was evaluated. RESULTS: Operation was performed in 20 patients with MEN1 and hypergastrinemia with a median follow-up of 71 months. Duodenal gastrinomas were identified in 85% of patients who underwent duodenal evaluation. Nodal metastases were identified in 80%. Patients who underwent anatomic regional lymph node dissection (RLND) had a median of 16 nodes removed, vs 1 in patients who did not undergo a formal regional lymphadenectomy. Eugastrinemia was achieved in 12 patients (60%), and 8 (40%) had persistent hypergastrinemia. Compared with patients with persistent hypergastrinemia, patients rendered eugastrinemic more often underwent duodenal evaluation (11/12 vs 2/8; P = .01) and RLND (11/12 vs 3/8; P = .03); there was no relationship between pancreatic resection and achievement of eugastrinemia (P = .32). CONCLUSION: For patients with MEN1-associated hypergastrinemia selected for operative treatment, a strategy including duodenal evaluation and anatomic regional lymphadenectomy is associated with long-term eugastrinemia. In contrast, the extent of pancreatic resection should be dictated by the extent and distribution of pancreatic neuroendocrine neoplasms, rather than by the presence of hypergastrinemia. |
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Authors:
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Paxton V Dickson; Thereasa A Rich; Yan Xing; Gilbert J Cote; Huamin Wang; Nancy D Perrier; Douglas B Evans; Jeffrey E Lee; Elizabeth G Grubbs |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Surgery Volume: 150 ISSN: 1532-7361 ISO Abbreviation: Surgery Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-05 Completed Date: 2012-02-06 Revised Date: 2012-06-20 |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: United States |
Other Details:
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Languages: eng Pagination: 1143-52 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011. Published by Mosby, Inc. |
Affiliation:
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Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4008, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen Adult Duodenal Neoplasms / blood, diagnosis, surgery* Female Gastrinoma / blood, surgery* Gastrins / blood* Humans Lymph Node Excision* Male Middle Aged Multiple Endocrine Neoplasia Type 1 / blood, surgery* Pancreatectomy* Pancreatic Neoplasms / blood, surgery* Pancreaticoduodenectomy Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Gastrins |
| Comments/Corrections | |
Comment In:
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Chirurg. 2012 May;83(5):480-1
[PMID:
22573248
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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