GASTROENTEROLOGY ARTICLE OF THE WEEK
April 17, 2008
Delaunoit T, Neczyporenko F, Rubin J, et al. Medical management of pancreatic neuroendocrine tumors. Am J Gastroenterol 2008;103;475-483.
1. Regarding surgical management of PNET’s
a. Surgery is not a consideration when metastatic disease to the liver is present
b. Debulking of tumor metastasis controls symptoms but does not improve survival
c. Surgery is the only curative intervention when the tumor is localized to the pancreas
d. Surgery is most effective if >90% of the tumor bulk can be removed
2. Typical side effects of long-term octreotide therapy for PNET include
a. gallstones
b. secretory diarrhea
c. steatorrhea
d. abdominal pain
3. Somatostatin therapy for PNET:
a. Octreotide is as effective as somatostatin in the treatment of PNET.
b. Increases survival
c. Is more likely to be effective in patients with slow tumor growth
d. During octreotide therapy, improvement in symptoms is more common than radiologic disease control
4. Symptoms and signs associated with glucagonoma include
a. necrolytic migratory erythema
b. Hypoglycemia
c. Venous thrombosis
d. Weight gain
5. Symptoms and signs associated with somatostinoma include
a. Diabetes
b. Gallstones
c. Steatorrhea
d. Abdominal pain
True or False
6. In advanced PNET disease, the most common cause of death is liver failure due to massive metastasis.
7. Over 75% of PNET secrete active products
8. Somatostatin receptors types 2&5 are present in approximately 80-90% of PNET cells
9. Radioactive octreotide may be an effective therapy for selected patient with PNET
10. Interferon therapy with or without somatostatin analogs may be helpful in a subset of patients with PNET
11. The main role of octreotide therapy in PNET is controlling tumor growth