clinicaloncologyКлинический случай в онкологииClinical Case in Oncology3034-14773034-4018ОНКОПРАКТИК10.62546/3034-1477-2024-2-4-52-66clinicaloncology-92Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCASE REPORTSЦиторедуктивные операции при нейроэндокринных опухолях тонкой кишкиDebulking surgery for small intestine neuroendocrine tumorshttps://orcid.org/0000-0003-0272-4240ДиникинМ. С.DinikinM. S.

Диникин Михаил СергеевичРоссия, 198255, Санкт-Петербург, пр. Ветеранов, д. 56

Dinikin Mikhail Sergeyevich56 Veteranov Ave., St. Petersburg, 198255, Russia

dinikin20@mail.ruhttps://orcid.org/0000-0003-0211-9809ИвановаА. К.IvanovaA. K.

Анастасия К. ИвановаРоссия, 198255, Санкт-Петербург, пр. Ветеранов, д. 56

Anastasia K. Ivanova56 Veteranov Ave., St. Petersburg, 198255, Russia

https://orcid.org/0000-0003-4447-9458ОрловаР. В.OrlovaR. V.

Рашида В. ОрловаРоссия, 198255, Санкт-Петербург, пр. Ветеранов, д. 56

Rashida V. Orlova56 Veteranov Ave., St. Petersburg, 198255, Russia

https://orcid.org/0000-0003-3647-0445ПелипасьЮ. В.PelipasYu. V.

Юрий В. ПелипасьРоссия, 198255, Санкт-Петербург, пр. Ветеранов, д. 56

Yuri V. Pelipas56 Veteranov Ave., St. Petersburg, 198255, Russia

СПб ГБУЗ «Городской клинический онкологический диспансер»РоссияSt. Petersburg City Clinical Oncology DispensaryRussian FederationСПб ГБУЗ «Городской клинический онкологический диспансер»; ФГБОУ ВО «Санкт-Петербургский государственный университет»РоссияSt. Petersburg City Clinical Oncology Dispensary; St. Petersburg State UniversityRussian Federation202428042025245266Copyright © Диникин М.С., Иванова А.К., Орлова Р.В., Пелипась Ю.В., 20252025Диникин М.С., Иванова А.К., Орлова Р.В., Пелипась Ю.В.Dinikin M.S., Ivanova A.K., Orlova R.V., Pelipas Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncocase.ru/jour/article/view/92

Нейроэндокринные опухоли (НЭО) включают гетерогенную группу новообразований, которые могут быть функционально или симптоматически активными (функционирующими) или нефункционирующими. Общая заболеваемость НЭО растет быстрее, чем заболеваемость всеми злокачественными новообразованиями человека. НЭО — вторая по распространенности злокачественная опухоль ЖКТ, характеризующаяся частым метастазированием в печень, что является основным фактором, влияющим на качество жизни и общую выживаемость пациентов. Циторедуктивные вмешательства при метастатическом поражении печени (NELM) является методом выбора, направленным на потенциальное продление жизни пациентов и улучшения контроля над гормональными симптомами, резистентных к лекарственному лечению. Хирургическая резекция метастазов показана для больных с высокодифференцированными (G1/G2) опухолями, в то время как ее осуществимость и сложность в значительной степени диктуются степенью поражения печени. В результате достижений в хирургических методах за последние десятилетия сложные 1- и 2-этапные или повторные резекции печени выполняются безопасно и  эффективно хирургами с  опытом лечения НЭО. Существует широкий спектр интервенционных радиологических методов лечения NELM с расширяющимися показаниями, являющихся важным дополнением или альтернативой хирургии. В целом, методы лечения, нацеленные на печень, могут предшествовать назначению системных молекулярных таргетных агентов и  химиотерапии для пациентов с  метастатической стадией и  доминирующим поражением печени, позволяя пациентам дольше оставаться только на  терапии аналогами соматостатина (АСС). Циторедуктивная хирургия НЭО не ограничивается только метастазами печени, но также применяется и при канцероматозе брюшины. Большая вариабельность клинических проявлений и распространенности опухолевого процесса определяет необходимость индивидуального подхода к лечению каждого пациента в рамках МДК. В настоящем сообщении мы обсуждаем хирургический подход к лечению метастатической НЭО тонкой кишки, нацеленный на первичную опухоль, метастазы в печени и канцероматоз брюшины. 

Neuroendocrine tumors (NETs) include heterogeneous neoplasms that can be functional or symptomatically active (functioning) or non-functioning. The overall incidence of NETs is growing faster than the incidence of all human malignancies. NETs are the second most common gastrointestinal cancers, characterized by frequent liver metastasis, which is a major factor affecting the quality of life and significant survival of patients. Cytoreductive treatment of liver metastases (NELM) is the method of choice aimed at ensuring prolongation of patient survival and improving control of hormonal symptoms resistant to conservative therapy. Surgical resection of metastases is indicated in patients with well-differentiated (G1/G2) tumors, while its feasibility and complexity in severity dictate the degree of liver involvement. As a result of advances in surgical techniques in recent years, 1- and 2-stage or repeat liver resections are performed safely and effectively by surgeons with the treatment of NETs. The wide range of interventional radiological treatments for NELM with limitations requires reasons, which is the basis for adjunctive or alternative surgery. In general, liver-directed therapies can precede the administration of systemic molecular targeted agents and chemotherapy for patients with metastatic stage and severe liver disease, which leads to the fact that patients continue to be treated only with somatostatin analogues (SAA). Cytoreductive surgery of NETs is not limited to liver metastases, but is also used in peritoneal carcinomatosis. The large variability of clinical manifestations and the prevalence of the tumor process determine the need for an individual regimen for each patient within the framework of the MDT. In this article, we discuss the surgical approach to metastatic small bowel NETs: primary tumor, liver metastases and peritoneal carcinomatosis.

нейроэндокринная опухольтонкая кишкакарциноидный синдромциторедуктивная операцияneuroendocrine tumorsmall intestinecarcinoid syndromedebulking surgeryReferencesPavel M., Oberg K. et al. ESMO Guidelines Committee. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up // Ann. Oncol. 2020. Vol. 31. Р. 844–860. doi: 10.1016/j.annonc.2020.03.304.Pavel M., Oberg K. et al. ESMO Guidelines Committee. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up // Ann. Oncol. 2020. Vol. 31. Р. 844–860. doi: 10.1016/j.annonc.2020.03.304.Clift A.K., Kidd M. et. al. Neuroendocrine Neoplasms of the Small Bowel and Pancreas // Neuroendocrinology. 2020. Vol. 110. Р. 444–476. doi: 10.1159/000503721.Clift A.K., Kidd M. et. al. Neuroendocrine Neoplasms of the Small Bowel and Pancreas // Neuroendocrinology. 2020. Vol. 110. Р. 444–476. doi: 10.1159/000503721.Modlin I.M., Shapiro M.D., Kidd M. Siegfried Oberndorfer: origins and perspectives of carcinoid tumors // Hum. Pathol. 2004. Vol. 35. Р. 1440–1451. doi: 10.1016/j.humpath.2004.09.018.Modlin I.M., Shapiro M.D., Kidd M. Siegfried Oberndorfer: origins and perspectives of carcinoid tumors // Hum. Pathol. 2004. Vol. 35. Р. 1440–1451. doi: 10.1016/j.humpath.2004.09.018.Modlin I.M., Lye K.D., Kidd M. A 5-decade analysis of 13,715 carcinoid tumors // Cancer. 2003. Vol. 97. Р. 934–959.Modlin I.M., Lye K.D., Kidd M. A 5-decade analysis of 13,715 carcinoid tumors // Cancer. 2003. Vol. 97. Р. 934–959.Kulke M.H., Shah M.H. et al. Neuroendocrine tumors, version 1.2015 // J. Natl. Compr. Canc Netw. 2015. Vol. 13. Р. 78–108.Kulke M.H., Shah M.H. et al. Neuroendocrine tumors, version 1.2015 // J. Natl. Compr. Canc Netw. 2015. Vol. 13. Р. 78–108.Dasari A., Shen C., Halperin D. et al. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States // JAMA Oncol. 2017. Vol. 3, No. 10. Р. 1335–1342.Dasari A., Shen C., Halperin D. et al. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States // JAMA Oncol. 2017. Vol. 3, No. 10. Р. 1335–1342.Артамонова Е.В., Горбунова В.А., Делекторская В.В. и др. Нейроэндокринные неоплазии желудочно-кишечного тракта и поджелудочной железы. Практические рекомендации RUSSCO, часть 1.1 // Злокачественные опухоли. 2024. Т. 14, № 3s2. С. 427–444.Артамонова Е.В., Горбунова В.А., Делекторская В.В. и др. Нейроэндокринные неоплазии желудочно-кишечного тракта и поджелудочной железы. Практические рекомендации RUSSCO, часть 1.1 // Злокачественные опухоли. 2024. Т. 14, № 3s2. С. 427–444.https://pubmed.ncbi.nlm.nih.gov/?term=small%20intestine%20neuroendocrine%20tumor&sort=date&timeline=expanded.https://pubmed.ncbi.nlm.nih.gov/?term=small%20intestine%20neuroendocrine%20tumor&sort=date&timeline=expanded.Boudreaux J.P., Wang Y.Z., Diebold A.E. et al. A single institution’s experience with surgical cytoreduction of stage IV, well-differentiated, small bowel neuroen-docrine tumors // J. Am. Coll Surg. 2014. Vol. 218. Р. 837–844.Boudreaux J.P., Wang Y.Z., Diebold A.E. et al. A single institution’s experience with surgical cytoreduction of stage IV, well-differentiated, small bowel neuroen-docrine tumors // J. Am. Coll Surg. 2014. Vol. 218. Р. 837–844.Vinik A., Moattari A.R. Use of somatostatin analog in management of carcinoid syndrome // Dig. Dis. Sci. 1989. Vol. 34, No. 3. Р. 14–27. doi: 10.1007/BF01536042. PMID: 2920654.Vinik A., Moattari A.R. Use of somatostatin analog in management of carcinoid syndrome // Dig. Dis. Sci. 1989. Vol. 34, No. 3. Р. 14–27. doi: 10.1007/BF01536042. PMID: 2920654.Barsouk A., Rawla P., Barsouk A., Thandra K.C. Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention // Med. Sci. (Basel). 2019. Vol. 7. PMID: 30884915 DOI: 10.3390/medsci7030046.Barsouk A., Rawla P., Barsouk A., Thandra K.C. Epidemiology of Cancers of the Small Intestine: Trends, Risk Factors, and Prevention // Med. Sci. (Basel). 2019. Vol. 7. PMID: 30884915 DOI: 10.3390/medsci7030046.Norlen O., Stalberg P., Oberg K. et al. Long-term results of surgery for small intestinal neuroendocrine tumors at a tertiary referral center // World J. Surg. 2012. Vol. 36. Р. 1419–1431.Norlen O., Stalberg P., Oberg K. et al. Long-term results of surgery for small intestinal neuroendocrine tumors at a tertiary referral center // World J. Surg. 2012. Vol. 36. Р. 1419–1431.Howe J.R., Cardona K., Fraker D.L. et al. The surgical management of small bowel neuroendocrine tumors: consensus guidelines of the North American neuroendocrine tumor society (NANETS) // Pancreas. 2017. Vol. 46. Р. 715–731.Howe J.R., Cardona K., Fraker D.L. et al. The surgical management of small bowel neuroendocrine tumors: consensus guidelines of the North American neuroendocrine tumor society (NANETS) // Pancreas. 2017. Vol. 46. Р. 715–731.Grozinsky-Glasberg S., Davar J., Hofland J. et al. European Neuroendocrine Tumor Society (ENETS) 2022 guidance paper for carcinoid syndrome and carcinoid heart disease // J. Neuroendocrinol. 2022. Vol. 34, No. 7. e13146.Grozinsky-Glasberg S., Davar J., Hofland J. et al. European Neuroendocrine Tumor Society (ENETS) 2022 guidance paper for carcinoid syndrome and carcinoid heart disease // J. Neuroendocrinol. 2022. Vol. 34, No. 7. e13146.Farley H.A., Pommier R.F. Treatment of neuroendocrine liver metastases // Surg. Oncol. Clin. N. Am. 2016. Vol. 25, No. 1. Р. 217–225.Farley H.A., Pommier R.F. Treatment of neuroendocrine liver metastases // Surg. Oncol. Clin. N. Am. 2016. Vol. 25, No. 1. Р. 217–225.Pavel M., O’Toole D., Costa F. et al. ENETS consensus guidelines update for the management of distant metastatic disease of intestinal, pancreatic, bronchial neuroendocrine neoplasms (NEN) and NEN of unknown primary site // Neuroendocrinology 2016. Vol. 103, No. 2. Р. 172–185.Pavel M., O’Toole D., Costa F. et al. ENETS consensus guidelines update for the management of distant metastatic disease of intestinal, pancreatic, bronchial neuroendocrine neoplasms (NEN) and NEN of unknown primary site // Neuroendocrinology 2016. Vol. 103, No. 2. Р. 172–185.Kelz R.R., Fraker D.L. Metastatic carcinoid: don’t forget the surgical consultation // Surgery. 2014. Vol. 156, No. 6. Р. 1367–1368.Kelz R.R., Fraker D.L. Metastatic carcinoid: don’t forget the surgical consultation // Surgery. 2014. Vol. 156, No. 6. Р. 1367–1368.Glazer E.S., Tseng J.F., Al-Refaie W. et al. Long-term survival after surgical management of neuroendocrine hepatic metastases // HPB (Oxford). 2010. Vol. 12, No. 6. Р. 427–433.Glazer E.S., Tseng J.F., Al-Refaie W. et al. Long-term survival after surgical management of neuroendocrine hepatic metastases // HPB (Oxford). 2010. Vol. 12, No. 6. Р. 427–433.Graff-Baker A.N., Sauer D.A., Pommier S.J. et al. Expanded criteria for carcinoid liver debulking: maintaining survival and increasing the number of eligible patients // Surgery. 2014. Vol. 156, No. 6. Р. 1369–1376.Graff-Baker A.N., Sauer D.A., Pommier S.J. et al. Expanded criteria for carcinoid liver debulking: maintaining survival and increasing the number of eligible patients // Surgery. 2014. Vol. 156, No. 6. Р. 1369–1376.Lamarca A., Bartsch D.K. еt al. European Neuroendocrine Tumor Society (ENETS) 2024 guidance paper for the management of well-differentiated small intestine neuroendocrine tumours // J. Neuroendocrinol. 2024. Vol. 36, No. 9. Р. 13423. doi: 10.1111/jne.13423.Lamarca A., Bartsch D.K. еt al. European Neuroendocrine Tumor Society (ENETS) 2024 guidance paper for the management of well-differentiated small intestine neuroendocrine tumours // J. Neuroendocrinol. 2024. Vol. 36, No. 9. Р. 13423. doi: 10.1111/jne.13423.Niederle B., Pape U.F. et al. ENETS Consensus Guidelines Update for Neuroendocrine Neoplasms of the Jejunum and Ileum // Neuroendocrinology. 2016. Vol. 103. Р. 125–138. doi: 10.1159/000443170.Niederle B., Pape U.F. et al. ENETS Consensus Guidelines Update for Neuroendocrine Neoplasms of the Jejunum and Ileum // Neuroendocrinology. 2016. Vol. 103. Р. 125–138. doi: 10.1159/000443170.Lardière-Deguelte S., de Mestier L., Appéré F. et al. Toward a Preoperative Classification of Lymph Node Metastases in Patients with Small Intestinal Neuroendocrine Tumors in the Era of Intestinal-Sparing Surgery // Neuroendocrinology. 2016. Vol. 103. Р. 552–559. doi: 10.1159/000441423.Lardière-Deguelte S., de Mestier L., Appéré F. et al. Toward a Preoperative Classification of Lymph Node Metastases in Patients with Small Intestinal Neuroendocrine Tumors in the Era of Intestinal-Sparing Surgery // Neuroendocrinology. 2016. Vol. 103. Р. 552–559. doi: 10.1159/000441423.Moris D., Ntanasis-Stathopoulos I., Tsilimigras D.I., Vagios S., Karamitros A., Karaolanis G., Griniatsos J., Papalampros A., Papaconstantinou I., Glantzounis G.K. et al. Update on Surgical Management of Small Bowel Neuroendocrine Tumors // Anticancer Res. 2018. Vol. 38. Р. 1267–1278. doi: 10.21873/anticanres.12349.Moris D., Ntanasis-Stathopoulos I., Tsilimigras D.I., Vagios S., Karamitros A., Karaolanis G., Griniatsos J., Papalampros A., Papaconstantinou I., Glantzounis G.K. et al. Update on Surgical Management of Small Bowel Neuroendocrine Tumors // Anticancer Res. 2018. Vol. 38. Р. 1267–1278. doi: 10.21873/anticanres.12349.De Mestier L., Lepage C., Baudin E. et al. Digestive Neuroendocrine Neoplasms (NEN): French Intergroup clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, GTE, RENATEN, TENPATH, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFR) // Dig. Liver Dis. 2020. Vol. 52. Р. 473–492. doi: 10.1016/j.dld.2020.02.011.De Mestier L., Lepage C., Baudin E. et al. Digestive Neuroendocrine Neoplasms (NEN): French Intergroup clinical practice guidelines for diagnosis, treatment and follow-up (SNFGE, GTE, RENATEN, TENPATH, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO, SFR) // Dig. Liver Dis. 2020. Vol. 52. Р. 473–492. doi: 10.1016/j.dld.2020.02.011.Keck K.J., Maxwell J.E., Utria A.F. et al. The distal predilection of small bowel neuroendocrine tumors // Ann. Surg. Oncol. 2018. Vol. 25. Р. 3207–3213. doi.org/10.1245/s10434-018-6676-2.Keck K.J., Maxwell J.E., Utria A.F. et al. The distal predilection of small bowel neuroendocrine tumors // Ann. Surg. Oncol. 2018. Vol. 25. Р. 3207–3213. doi.org/10.1245/s10434-018-6676-2.Pasquer A., Walter T., Hervieu V. et al. Surgical management of small bowel neuroendocrine tumors: specific requirements and their impact on staging and prognosis // Ann. Surg. Oncol. 2015. Vol. 22, No. 3. Р. 742–749. doi: 10.1245/s10434-015-4620-2.Pasquer A., Walter T., Hervieu V. et al. Surgical management of small bowel neuroendocrine tumors: specific requirements and their impact on staging and prognosis // Ann. Surg. Oncol. 2015. Vol. 22, No. 3. Р. 742–749. doi: 10.1245/s10434-015-4620-2.Strosberg J., Weber J.M., Feldman M. et al. Prognostic validity of the american joint committee on Cancer staging classification for midgut neuroendocrine tumors // J. Clin. Oncol. 2013. Vol. 31. Р. 420–425. doi.org/10.1200/JCO.2012.44.5924.Strosberg J., Weber J.M., Feldman M. et al. Prognostic validity of the american joint committee on Cancer staging classification for midgut neuroendocrine tumors // J. Clin. Oncol. 2013. Vol. 31. Р. 420–425. doi.org/10.1200/JCO.2012.44.5924.Ohrvall U., Eriksson B., Juhlin C. et al. Method for dissection of mesenteric metastases in mid-gut carcinoid tumors. World J. Surg. 2000. Nov. Vol. 24 (11). P. 1402–1408. doi: 10.1007/s002680010232.Ohrvall U., Eriksson B., Juhlin C. et al. Method for dissection of mesenteric metastases in mid-gut carcinoid tumors. World J. Surg. 2000. Nov. Vol. 24 (11). P. 1402–1408. doi: 10.1007/s002680010232.Kaltsas G.A., Besser G.M., Grossman A.B. The diagnosis and medical management of advanced neuroendocrine tumors // Endocr. Rev. 2004. Vol. 25, No. 3. Р. 458–511.Kaltsas G.A., Besser G.M., Grossman A.B. The diagnosis and medical management of advanced neuroendocrine tumors // Endocr. Rev. 2004. Vol. 25, No. 3. Р. 458–511.Sarmiento J.M., Heywood G., Rubin J. et al. Surgical treatment of neuroendocrine metastases to the liver: a plea for resection to increase survival // J. Am. Coll Surg. 2003. Vol. 197, No. 1. Р. 29–37.Sarmiento J.M., Heywood G., Rubin J. et al. Surgical treatment of neuroendocrine metastases to the liver: a plea for resection to increase survival // J. Am. Coll Surg. 2003. Vol. 197, No. 1. Р. 29–37.Kulkarni R., Kabir I., Hodson J. et al. Impact of the extent of resection of neuroendocrine tumor liver metastases on survival: A systematic review and meta-analysis // Ann. Hepatobiliary Pancreat Surg. 2022. Vol. 26, No. 1. Р. 31–39. doi: 10.14701/ahbps.21-101.Kulkarni R., Kabir I., Hodson J. et al. Impact of the extent of resection of neuroendocrine tumor liver metastases on survival: A systematic review and meta-analysis // Ann. Hepatobiliary Pancreat Surg. 2022. Vol. 26, No. 1. Р. 31–39. doi: 10.14701/ahbps.21-101.Metz D.C., Jensen R.T. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors // Gastroenterology. 2008. Vol. 135. Р. 1469–1492.Metz D.C., Jensen R.T. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors // Gastroenterology. 2008. Vol. 135. Р. 1469–1492.Chamberlain R.S., Canes D., Brown K.T. et al. Hepatic neuroendocrine metastases: does intervention alter outcomes? // J. Am. Coll Surg. 2000. Vol. 190. Р. 432–445.Chamberlain R.S., Canes D., Brown K.T. et al. Hepatic neuroendocrine metastases: does intervention alter outcomes? // J. Am. Coll Surg. 2000. Vol. 190. Р. 432–445.Maxwell J.E., Sherman S.K., O’Dorisio T.M. et al. Liver-directed surgery of neuroendocrine metastases: what is the optimal strategy? // Surgery. 2016. Vol. 159. Р. 320–333.Maxwell J.E., Sherman S.K., O’Dorisio T.M. et al. Liver-directed surgery of neuroendocrine metastases: what is the optimal strategy? // Surgery. 2016. Vol. 159. Р. 320–333.Chambers A.J., Pasieka J.L., Dixon E. et al. The palliative benefit of aggressive surgical intervention for both hepatic and mesenteric metastases from neuroendocrine tumors // Surgery. 2008. Vol. 144. Р. 645–651.Chambers A.J., Pasieka J.L., Dixon E. et al. The palliative benefit of aggressive surgical intervention for both hepatic and mesenteric metastases from neuroendocrine tumors // Surgery. 2008. Vol. 144. Р. 645–651.Lewis A., Raoof M., Ituarte PHG. et al. Resection of the Primary Gastrointestinal Neuroendocrine Tumor Improves Survival With or Without Liver Treatment // Ann. Surg. 2019. Vol. 270, No. 6. Р. 1131–1137. doi: 10.1097/SLA.0000000000002809.Lewis A., Raoof M., Ituarte PHG. et al. Resection of the Primary Gastrointestinal Neuroendocrine Tumor Improves Survival With or Without Liver Treatment // Ann. Surg. 2019. Vol. 270, No. 6. Р. 1131–1137. doi: 10.1097/SLA.0000000000002809.Caplin M.E., Pavel M., Ćwikła J.B. et al. Lanreotide in metastatic enteropancreatic neuroendocrine tumors // N. Engl. J. Med. 2014. Vol. 371. Р. 224–233.Caplin M.E., Pavel M., Ćwikła J.B. et al. Lanreotide in metastatic enteropancreatic neuroendocrine tumors // N. Engl. J. Med. 2014. Vol. 371. Р. 224–233.Rinke A., Muller H.H., Schade-Brittinger C. et al. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group // J. Clin. Oncol. 2009. Vol. 27. Р. 4656–4663.Rinke A., Muller H.H., Schade-Brittinger C. et al. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group // J. Clin. Oncol. 2009. Vol. 27. Р. 4656–4663.Strosberg J., El-Haddad G., Wolin E. et al. Phase 3 trial of 177Lu-DOTATATE for midgut neuroendocrine tumors // N. Engl. J. Med. 2017. Vol. 376. Р. 125–135.Strosberg J., El-Haddad G., Wolin E. et al. Phase 3 trial of 177Lu-DOTATATE for midgut neuroendocrine tumors // N. Engl. J. Med. 2017. Vol. 376. Р. 125–135.Yao J.C., Fazio N., Singh S. et al. Everolimus for the treatment of advanced, non-functional neuroendocrine tumours of the lung or gastrointestinal tract (RADIANT-4): a randomised, placebo-controlled, phase 3 study // Lancet. 2016. Vol. 387. Р. 968–977.Yao J.C., Fazio N., Singh S. et al. Everolimus for the treatment of advanced, non-functional neuroendocrine tumours of the lung or gastrointestinal tract (RADIANT-4): a randomised, placebo-controlled, phase 3 study // Lancet. 2016. Vol. 387. Р. 968–977.Makridis C., Rastad J., Oberg K. et al. Progression of metastases and symptom improvement from laparotomy in midgut carcinoid tumors // World J. Surg. 1996. Vol. 20. Р. 900–906.Makridis C., Rastad J., Oberg K. et al. Progression of metastases and symptom improvement from laparotomy in midgut carcinoid tumors // World J. Surg. 1996. Vol. 20. Р. 900–906.Hellman P., Lundstrom T., Ohrvall U. et al. Effect of surgery on the outcome of midgut carcinoid disease with lymph node and liver metastases // World J. Surg. 2002. Vol. 26. Р. 991–997.Hellman P., Lundstrom T., Ohrvall U. et al. Effect of surgery on the outcome of midgut carcinoid disease with lymph node and liver metastases // World J. Surg. 2002. Vol. 26. Р. 991–997.Wonn S.M., Limbach K.E., Pommier S.J. et al. Outcomes of cytoreductive operations for peritoneal carcinomatosis with or without liver cytoreduction in patients with small bowel neuroendocrine tumors // Surgery. 2020. Vol. 169, No. 1. Р. 168–174. doi: 10.1016/j.surg.2020.03.030.Wonn S.M., Limbach K.E., Pommier S.J. et al. Outcomes of cytoreductive operations for peritoneal carcinomatosis with or without liver cytoreduction in patients with small bowel neuroendocrine tumors // Surgery. 2020. Vol. 169, No. 1. Р. 168–174. doi: 10.1016/j.surg.2020.03.030.Gilly F.N., Cotte E., Brigand C. et al. Quantitative prognostic indices in peritoneal carcinomatosis // Eur. J. Surg. Oncol. 2006. Vol. 32. Р. 597–601.Gilly F.N., Cotte E., Brigand C. et al. Quantitative prognostic indices in peritoneal carcinomatosis // Eur. J. Surg. Oncol. 2006. Vol. 32. Р. 597–601.Sadeghi B., Arvieux C., Glehen O. et al. Peritoneal carcinomatosis from non- gynecologic malignancies: results of the EVOCAPE 1 multicentric prospective study // Cancer. 2000. Vol. 88. Р. 358–363.Sadeghi B., Arvieux C., Glehen O. et al. Peritoneal carcinomatosis from non- gynecologic malignancies: results of the EVOCAPE 1 multicentric prospective study // Cancer. 2000. Vol. 88. Р. 358–363.De Mestier L., Lardière-Deguelte S., Brixi H. et al. Updating the surgical management of peritoneal carcinomatosis in patients with neuroendocrine tumors // Neuroendocrinology. 2015. Vol. 101. Р. 105–111. doi.org/10.1159/000371817.De Mestier L., Lardière-Deguelte S., Brixi H. et al. Updating the surgical management of peritoneal carcinomatosis in patients with neuroendocrine tumors // Neuroendocrinology. 2015. Vol. 101. Р. 105–111. doi.org/10.1159/000371817.Elias D., David A., Sourrouille I. et al. Neuroendocrine carcinomas: optimal surgery of peritoneal metastases (and associated intra-abdominal metastases) // Surgery. 2014. Vol. 155. Р. 5–12. doi.org/10.1016/j.surg.2013.05.030.Elias D., David A., Sourrouille I. et al. Neuroendocrine carcinomas: optimal surgery of peritoneal metastases (and associated intra-abdominal metastases) // Surgery. 2014. Vol. 155. Р. 5–12. doi.org/10.1016/j.surg.2013.05.030.Kianmanesh R., Ruszniewski P., Rindi G. et al. ENETS consensus guidelines for the management of peritoneal carcinomatosis from neuroendocrine tumors // Neuroendocrinology. 2010. Vol. 91. Р. 333–340. doi.org/10.1159/000286700.Kianmanesh R., Ruszniewski P., Rindi G. et al. ENETS consensus guidelines for the management of peritoneal carcinomatosis from neuroendocrine tumors // Neuroendocrinology. 2010. Vol. 91. Р. 333–340. doi.org/10.1159/000286700.Woltering E.A., Voros B.A., Beyer D.T. et al. Aggressive surgical approach to the management of neuroendocrine tumors: a report of 1,000 surgical cytoreductions by a single institution // J. Am. Coll Surg. 2017. Vol. 224. Р. 434–447.Woltering E.A., Voros B.A., Beyer D.T. et al. Aggressive surgical approach to the management of neuroendocrine tumors: a report of 1,000 surgical cytoreductions by a single institution // J. Am. Coll Surg. 2017. Vol. 224. Р. 434–447.Scott A.Е., Pelletier D., Maxwell J.E. et al. The Pancreas as a Site of Metastasis or Second Primary in Patients with Small Bowel Neuroendocrine Tumors // Ann. Surg. Oncol. 2019. Vol. 26, No. 8. Р. 2525–2532. doi: 10.1245/s10434-019-07370-3.Scott A.Е., Pelletier D., Maxwell J.E. et al. The Pancreas as a Site of Metastasis or Second Primary in Patients with Small Bowel Neuroendocrine Tumors // Ann. Surg. Oncol. 2019. Vol. 26, No. 8. Р. 2525–2532. doi: 10.1245/s10434-019-07370-3.Saxena A., Chua T.C., Perera M. et al. Surgical resection of hepatic metastases from neuroendocrine neoplasms: a systematic review // Surg. Oncol. 2012. Vol. 21, No. 3. Р. 131–141. doi: 10.1016/j.suronc.2012.05.001.Saxena A., Chua T.C., Perera M. et al. Surgical resection of hepatic metastases from neuroendocrine neoplasms: a systematic review // Surg. Oncol. 2012. Vol. 21, No. 3. Р. 131–141. doi: 10.1016/j.suronc.2012.05.001.

The authors declare that there are no conflicts of interest present.