Hepatic Resection for Metastatic Neuroendocrine Cancer in Patients with Bone Metastases

Croome, Kristopher P.; Burns, Justin M.; Que, Florencia G.; Nagorney, David M.

doi:10.1245/s10434-016-5274-4

Cited by 7 publications

(5 citation statements)

References 14 publications

(18 reference statements)

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“…Prior studies have suggested that surgical resection of the primary tumor without metastasectomy [23][24][25][26][27] and liver metastasectomy alone [28][29][30][31] both independently provide a survival benefit. Current NCCN guidelines also recommend complete resection of metastatic disease if possible [32].…”

Section: Discussionmentioning

confidence: 99%

Examining Perioperative Risk Associated with Simultaneous Resection of Primary Neuroendocrine Tumors and Synchronous Hepatic Metastases

Heidenreich¹,

Bohan

Flor³

et al. 2020

World j. surg.

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Background Surgical debulking of primary neuroendocrine tumors (NETs) and hepatic resection of metastatic NET disease may each independently improve overall survival. However, evidence for combined primary site debulking and metastasectomy on survival and impact on short‐term perioperative outcomes is limited. Methods The 2014–2016 ACS‐NSQIP targeted hepatectomy database was queried for all patients undergoing liver resection for metastatic NET. Secondary procedure codes were evaluated for major concurrent operations. Multivariable analysis was performed to determine risk factors for 30‐day morbidity and mortality. Results A total of 472 patients were identified, of whom 153 (32.4%) underwent ≥1 additional concurrent major operation. The most common concurrent procedures were small bowel resection (14.6%), partial colectomy (8.9%), and radical lymphadenectomy (7.4%). Among all patients, overall 30‐day mortality and morbidity were 1.5% and 25.6%, respectively. Modifiable and treatment‐related factors associated with increased major postoperative morbidity risk included >10% weight loss within six months of surgery (p = 0.05), increasing number of hepatic lesions treated (p = 0.05), and biliary reconstruction (p = 0.001). No major concurrent procedure was associated with increased 30‐day morbidity (all p > 0.05). Conclusions Approximately one‐third of patients with stage IV NET underwent combined hepatic and multi‐organ resection. Although modifiable and treatment‐related factors predictive of perioperative morbidity were identified, performance of concurrent major procedures did not increase perioperative morbidity. These results support consideration of multi‐organ resection in carefully selected patients with metastatic NET.

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Section: Discussionmentioning

confidence: 99%

Examining Perioperative Risk Associated with Simultaneous Resection of Primary Neuroendocrine Tumors and Synchronous Hepatic Metastases

Heidenreich¹,

Bohan

Flor³

et al. 2020

World j. surg.

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“…The median survival was 73.3 months for patients with liver and bone metastases from GI NET. 14 Analysis of NEN survival rates from the SEER database found that the median overall survival (OS) for all NEN patients was 9.3 years in the United States. Well-differentiated 2 Clinical Medicine Insights: Endocrinology and Diabetes tumors were found to have higher OS than moderately differentiated tumors (16.2 vs 8.3 years).…”

Section: Epidemiologymentioning

confidence: 99%

Management of Gastrointestinal Neuroendocrine Tumors

Wang

Zheng-Pywell

Chen

et al. 2019

Clin Med Insights Endocrinol Diabetes

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Neuroendocrine neoplasms (NENs) are derived from neuroendocrine cell system and can have benign or malignant characteristics. They are rare tumors, but have been increasing in incidence over the past 40 years. Patients with NENs may develop symptoms due to primary tumor invasion, metastasis, or from secretion of hormonally active tumor substances. Multiple imaging modalities are used for diagnosis and staging, including specialty scans such as 111In pentetreotide (Octreoscan) and 68Gallium-DOTATATE, along with endoscopy, endoscopic ultrasound, and biochemical marker testing. Treatment involves both surgical approach, for both primary and metastatic lesions, as well as medical management for symptom management and disease progression. This article will review the current clinical knowledge regarding the diagnosis, treatment, and prognosis of these fascinating neoplasms and the associated hormonal syndromes.

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“…In a systematic review, Saxena et al noted that poor histologic grade, extrahepatic disease, and a macroscopically incomplete resection were negative prognostic factors (21). While extrahepatic metastatic disease is one of the most consistent prognostic factors observed across studies, hepatic resection in the setting of low-volume indolent bone metastases may be appropriate (30). In addition, synchronous disease is associated with higher recurrence rates compared with metachronous disease (31).…”

Section: Prognostic Factorsmentioning

confidence: 99%

Neuroendocrine liver metastases: a contemporary review of treatment strategies

Cloyd

Ejaz

Konda

et al. 2020

Hepatobiliary Surg Nutr

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patients developing neuroendocrine liver metastases (NELM) in their lifetime (1,2). NELM can be associated with significant detriments in quality and quantity of life (3). Indeed, the presence of NELM is one of the most significant negative prognostic factors for long-term survival among patients with NETs (4). In addition, patients with liver metastases can experience debilitating carcinoid syndrome, as well as local complications such as biliary obstruction or liver insufficiency (5,6). For these reasons,

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Hepatic Resection for Metastatic Neuroendocrine Cancer in Patients with Bone Metastases

Abstract: The present study is the first report to describe HR for patients with metastatic NET and known bone metastases. We demonstrated that in properly selected cases, excellent survival can be achieved with liver debulking in these patients.

Cited by 7 publications

References 14 publications

Examining Perioperative Risk Associated with Simultaneous Resection of Primary Neuroendocrine Tumors and Synchronous Hepatic Metastases

Examining Perioperative Risk Associated with Simultaneous Resection of Primary Neuroendocrine Tumors and Synchronous Hepatic Metastases

Management of Gastrointestinal Neuroendocrine Tumors

Neuroendocrine liver metastases: a contemporary review of treatment strategies

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