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Watchful Waiting for Small Nonfunctioning Pancreatic Neuroendocrine Tumors ?

Pancreatic neuroendocrine tumors can roughly be divided into functioning and non-functioning categories. The functioning tumors produce an abundance of a given hormone such that the clinical effects of this overabundance can be observed or felt by physicians and/or patients. Non-functioning pancreatic neuroendocrine tumors produce no hormone, or produce such hormones in sub-clinical quantity, or produce hormones which are not presently known and in which there is no apparent clinical effect.

Surgical researchers from the Mayo Clinic in the journal Surgery have published their results of a decade long study based on comparing non-surgical “watchful waiting” of almost eighty patients with small non-functioning pancreatic neuroendocrine tumors with the outcomes of 56 patients who were treated with surgery. Subjects were included in the study if their tumor was less than four centimeters in diameter without any apparent metastases or other evidence of spread.

They found that the watchful observation approach was worth advocating when interval radiographic studies show no or small growth or change of a solitary pancreatic neuroendocrine tumor, which they observed was quite frequent.

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Dale O’Brien, MD