caa a22 4500 477035345 CHVBK 20180405111303.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/s002689900133 doi (NATIONALLICENCE)springer-10.1007/s002689900133 Surgery for Asymptomatic Pancreatic Lesion in Multiple Endocrine Neoplasia Type I [Elektronische Daten] [B. Skogseid, K. Öberg, B. Eriksson, C. Juhlin, D. Granberg, G. Åkerström, J. Rastad] Abstract. Patients with multiple endocrine neoplasia (MEN) type I underwent pancreatic surgery at presymptomatic (: n = 8, mean age 33 years) or symptomatic ( n = 12, mean age 51 years) stages of pancreatic endocrine involvement with the principal aim to evaluate postoperative morbidity, survival, and malignant potential of the pancreatic lesion. Radiologic signs of malignancy were not identified in any patient prior to exploration. All patients displayed multiple tumors with generally complex immunoreactivity. Normal postoperative pancreatic tumor markers were recorded in five of the asymptomatic patients, which became abnormal in three of them at a mean of 3 years after surgery. All patients remained without symptoms for a mean of 6 years after operation. In four symptomatic individuals (33%) metastases were identified at exploration, and two died with tumor; 83% of symptomatic patients displayed persistent or recurrent endocrine morbidity from the pancreatic lesion. Recognizing lead time bias, this limited and uncontrolled patient comparison suggests that exploration at the symptomatic stage of pancreatic involvement in MEN-I patients is unsatisfactory. Rather than to obtain biochemical cure, surgery in asymptomatic patients might be regarded as a means of cancer prevention. The malignancy of the pancreatic lesion may be preceded by several decades of biochemical abnormality. Extensive screening for this lesion allows diagnosis during adolescence and the timely application of primary exploration. Active management of individuals with repeated biochemical analyses followed by selective reintervention could enable satisfactorily maintained pancreatic functions and substantial duration of cancer prevention. 1996 by the Société Internationale de Chir, ugie Skogseid B. Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut Öberg K. Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut Eriksson B. Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut Juhlin C. Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut Granberg D. Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut Åkerström G. Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut Rastad J. Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut https://doi.org/10.1007/s002689900133 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900133 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Skogseid B. Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Öberg K. Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Eriksson B. Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Juhlin C. Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Granberg D. Department of Internal Medicine, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Åkerström G. Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut NATIONALLICENCE 700 1- Rastad J. Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden, SE aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer