Surgery

Surgery is a common treatment for neuroendocrine tumors. Sixty percent of patients reported having surgery.² The type of surgery depends on tumor site, grade, stage, and disease burden. Surgeons also consider a patient’s age, overall health, and any other chronic diseases as criteria for surgical treatment options. Surgery can sometimes remove early stage tumors that have not spread, offering patients a curative treatment.²⁰ In advanced cases, surgery can reduce tumor bulk to treat symptoms and improve quality of life.¹⁷

Pancreatic neuroendocrine tumor surgery ⁶

• Cytoreduction: Surgery to remove cancer that has spread to the other parts of the body, including the liver, may also be called “debulking” surgery.
• Distal pancreatectomy: Surgery to remove the body and tail of the pancreas. The spleen may also be removed if cancer has spread to the spleen.
• Enucleation: Surgery to remove the tumor only. This may be done when cancer occurs in one place in the pancreas.
• Liver resection: Surgery to remove part or all of the liver.
• Pancreatoduodenectomy (Whipple Surgery): A surgical procedure in which the head of the pancreas, the gallbladder, nearby lymph nodes and part of the stomach, small intestine, and bile duct are removed. Enough of the pancreas is left to make digestive juices. The organs removed during this procedure depend on the patient’s condition.

Gastrointestinal tumor surgery^21,22

• Appendectomy: Surgery to remove the appendix.
• Cholecystectomy: Surgery to remove the gallbladder. 
• Cryosurgery: A treatment that uses an instrument to freeze and destroy neuroendocrine tumor tissue. This type of treatment is also called cryotherapy. The doctor may use ultrasound to guide the instrument.
• Cytoreduction: Surgery to remove cancer that has spread to the other parts of the body, including the liver, may also be called “debulking” surgery.
• Endoscopic resection: Surgery to remove a small tumor that is on the inside lining of the GI tract. An endoscope is inserted through the mouth and passed through the esophagus to the stomach and sometimes, the duodenum. An endoscope is a thin, tube-like instrument with a light, a lens for viewing, and a tool for removing tumor tissue.
• Gastrectomy: Surgery to remove all or part of the stomach.
• Liver resection: Surgery to remove portions of the liver where cancer can be found.
• Liver transplant: Surgery to remove the whole liver and replace it with a healthy donated liver.
• Local excision: Surgery to remove the tumor and a small amount of normal tissue around it.
• Resection: Surgery to remove part or all of the organ that contains cancer. Nearby lymph nodes may also be removed.
• Segmental colon resection or hemicoloectomy: Removing part of the colon as well as nearby tissue, blood vessels, and nearby lymph nodes.
• Small bowel resection: Surgery to remove all or parts of the small intestine and nearby organs where cancer may have spread.
• Types of abdominoperineal resection (APR): A major surgery that may be conducted using different approaches to remove the anus, the rectum, and part of the sigmoid colon through an incision made in the abdomen. The end of the intestine is attached to an opening in the surface of the abdomen and body waste is collected in a disposable bag outside of the body. This opening is called a colostomy. Lymph nodes that contain cancer may also be removed during this operation.

Lung neuroendocrine tumor surgery¹⁰ 

• Lobectomy: Surgery to remove a whole lobe of the lung.
  Lymph node dissection: Surgery to remove lymph nodes to check for or prevent the spread of cancer.
• Pneumonectomy: Surgery to remove one whole lung.
• Sleeve resection: Surgery to remove the tumor and part of the bronchus (airway). Sometimes called “lung-sparing” surgery. 
• Wedge resection: Surgery to remove a tumor and some of the healthy tissue around it in the shape of a small wedge. If a larger amount of tissue is taken, it is called a segmental resection.
• Liver resection: Surgery to remove part or all of the liver.