Types of Neuroendocrine Tumor Surgery

At Stanford, you have access to the most advanced surgical techniques for neuroendocrine tumors, along with the most advanced treatments before, after, or instead of surgery. We’ll work with you to create an integrated care plan to help eliminate tumors and minimize symptoms as much as possible.

Surgical excision or resection
We may be able to remove a tumor using local excision, which removes the tumor and its margins (a small amount of normal tissue around it). Or we may perform a resection to remove part of the organ where the tumor is located. If cancer has spread to nearby lymph nodes, we also remove those lymph nodes.

Endoscopic resection
Your doctor may remove neuroendocrine tumors in the lining of the gastrointestinal (GI) tract using an endoscope (a long, narrow tube with a light). The endoscope is inserted through your mouth and passes through the esophagus into the stomach, the duodenum (the upper small intestine), or the colon and rectum. Using tiny tools, the doctor can view the GI tract and remove tumor tissue.

Radioguided surgery
We continue to investigate new, effective surgical techniques, including radioguided surgery to enable us to more completely remove cancerous or potentially cancerous tumors. Radioguided surgery uses radioactive markers such as Gallium-68 dotatate to “tag” cancerous cells. The surgeon uses a probe to spot the tagged cells and remove them.

Debulking surgery
At times, we recommend debulking surgery to make a tumor smaller, especially in the case of liver metastasis (tumors that have spread to the liver). Debulking surgery can decrease your discomfort and other symptoms of a neuroendocrine tumor.

Radiofrequency ablation

We sometimes destroy cancer cells by inserting a probe that releases high-energy ultrasound waves or freezes (cryoablation) a neuroendocrine tumor. Radiofrequency ablation and cryoablation are minimally invasive procedures that we may use in addition to or instead of surgery. 

Hepatic artery embolization
When a tumor spreads to the liver, we are sometimes able to destroy the cancer cells growing there by blocking blood flow to the tumor. Hepatic artery embolization blocks the hepatic artery, one main blood vessel that brings blood into the liver, to starve the tumor of nutrients.

We also use chemoembolization, which injects anticancer medication into the tumor and then blocks blood flow to the tumor. With both processes, healthy liver cells still receive blood flow from another blood vessel, the portal vein.

Liver transplant
In some cases where the neuroendocrine tumor is in the liver, you may be a candidate for liver transplantation. A liver transplant removes your liver and replaces it with a healthy liver from a donor.

After surgery
For neuroendocrine tumors that are localized (located in one area), surgery may be the only treatment needed. Some people need medical therapy (chemotherapy or targeted therapy) or radioisotope therapy (a new therapy that uses radioactive proteins to destroy tumor cells) before or after surgery. These treatments can shrink a tumor or control symptoms.

After you have surgery for a neuroendocrine tumor, we support you, your family, and your relationship with your community doctors. We will monitor you for recurrence (a tumor that returns). If we cannot remove the tumor completely, we work to minimize your symptoms so that they interfere as little as possible with your quality of life.

Our extensive survivorship services include nutrition advice customized to people with gastroenteropancreatic neuroendocrine tumors.