Surgical Options

Complete removal of the tumour and surrounding tissue.
Involves the removal of a large portion of the tumour or cancerous cells to potentially increase the effectiveness of chemotherapy or radiation therapy that will follow. Cytoreductive procedures are also called debulking surgery.
Surgical procedures that are aimed at controlling symptoms caused by a tumour when maintaining quality of life is the primary goal.

Evidence for Surgical Options

Surgical approaches:

  • Canadian National Carcinoid Expert Group guidelines recommend
    • consider surgery for cure, maximal debulking, or symptom palliation
    • cytoreductive surgery at earliest opportunity
    • short-acting octreotide should be given before surgery
  • Consensus recommendations for management of neuroendocrine tumors of gastroenteropancreatic system
    • surgical resection may have any of the following goals
      • curative intent for primary and regional lesions
      • palliative intent for primary and regional lesions
      • cytoreductive intent for regional or distant metastatic disease
    • cytoreductive surgery may include
      • tumor resection
      • radiofrequency ablation
      • cryotherapy
    • cholecystectomy
      • recommended in patients having surgical abdominal exploration
      • rationale to prevent cholelithiasis which is common side effect of somatostatin analog
  • no randomized trials identified to evaluate palliative cytoreductive surgery in nonresectable liver metastases from gastroenteropancreatic neuroendocrine tumors
  • no trials identified evaluating liver resection for resectable liver metastases from gastroenteropancreatic neuroendocrine tumors
  • rectal tumors < 1 cm successfully treated with excision

Surgical Options Resources

Dr. Calvin Law

Dr. Calvin Law

Videos on Surgical Procedures

Here you will find a collection of patient and family specific 3D computer animations that explain common liver, pancreas and transplant surgeries performed at Toronto General Hospital. These animations describe the general steps in the procedure, the risks and complications of the surgery, as well as post-operative care and discharge information.

Surgical Procedures