Therapy
The treatment of a patient with Zollinger-Ellison syndrome should always be individualized, and several factors play an important role in the decision making process. If only one tumor is known and easily localized in a patient, surgical removal of the tumor should be attempted. It is problematic, however, that many patients have several gastrinomas at the same time and that these are difficult to localize due to their small size, which makes surgery considerably more difficult.
In any case, a symptomatic therapy should be performed to counteract the breakthrough of an ulcer, bleeding and diarrhea. Proton pump inhibitors such as omeprazole, which counteract the production of gastric acid, are mainly used here. Proton pump inhibitors are drugs that are taken in tablet form and are generally well tolerated. They act by directly inhibiting the proton pump in certain cells of the stomach, which is crucial for acid production. Patients who cannot be operated on have the option of undergoing chemotherapy.
Prognosis
It is estimated that about two thirds of all gastrinomas (Zollinger-Ellison syndrome) are malignant, which means that these tumors form metastases, i.e. daughter tumors, early on, which can then spread to other organs. Depending on the location of the tumor and the possible presence of metastases, the prognosis of a gastrinoma varies.The overall survival after five years is about 90% for gastrinomas with lymph node metastases, if the metastases have also reached the liver, the prognosis is worse, gastrinomas with metastases in the pancreas also have a worse prognosis.