Indications and results of liver resection and hepatic chemoembolization for metastatic gastrointestinal neuroendocrine tumors

Yao, Kathy; Talamonti, Mark S.; Nemcek, Albert A.; Angelos, Peter; Chrisman, Howard B.; Skarda, Janet; Benson, Al B.; Rao, Sambasiva; Joehl, Raymond J.

doi:10.1067/msy.2001.117377

Cited by 207 publications

(120 citation statements)

References 15 publications

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“…However, the overall survival after hepatic resection has been reported in 46-86% at 5 years and 35-79% at 10 years (49,59,60,61,62,63,64,65,66,67,68,69,70,71,72). This wide heterogeneity reflects the selection bias that is present in the majority of series.…”

Section: Surgery Of Lmmentioning

confidence: 87%

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

Partelli

Maurizi

Tamburrino

et al. 2014

European Journal of Endocrinology

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The incidence of neuroendocrine tumors (NETs) has increased in the last decades. Surgical treatment encompasses a panel of approaches ranging from conservative procedures to extended surgical resection. Tumor size and localization usually represent the main drivers in the choice of the most appropriate surgical resection. In the presence of small (!2 cm) and asymptomatic nonfunctioning NETs, a conservative treatment is usually recommended. For localized NETs measuring above 2 cm, surgical resection represents the cornerstone in the management of these tumors. As they are relatively biologically indolent, an extended resection is often justified also in the presence of advanced NETs. Surgical options for NET liver metastases range from limited resection up to liver transplantation. Surgical choices for metastatic NETs need to consider the extent of disease, the grade of tumor, and the presence of extra-abdominal disease. Any surgical procedures should always be balanced with the benefit of survival or relieving symptoms and patients' comorbidities.

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Section: Surgery Of Lmmentioning

confidence: 87%

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

Partelli

Maurizi

Tamburrino

et al. 2014

European Journal of Endocrinology

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“…Chemoembolization is where the hepatic arterial injection is with local cytotoxic chemotherapy, which has given response rates of 63% for symptoms and mean survival of 2 years (Stokes et al 1993, Wallace et al 1996, Ruszniewski & Malka 2000. When compared with curative hepatic resections, it provided a median survival from treatment of 32 months and an actuarial 5-year survival of 40% (Yao et al 2001). Finally, the procedure of radioembolization has been attempted for hepatic metastases of NETs, where microspheres labelled with radio-isotope (for example yttrium 90) are used to occlude the hepatic arterial branches supplying the metastases.…”

Section: Treatment With Interventional Radiologymentioning

confidence: 99%

“…Increasingly now, surgeons are even attempting curative surgery of metastases when confined to the liver and where there is sufficient hepatic reserve (Que et al 1995, Chen et al 1998, Chamberlain et al 2000, Jaeck et al 2001, Yao et al 2001, with 4-5 year survival between 70-85%. Outcomes were best with previous resections of the primary tumour and with fewer than 5 liver lesions (Yao et al 2001). In selected patients with numerous liver metastases, liver transplantation has been performed, with survival of 52% after 1 year (Bechstein & Neuhaus 1994).…”

Section: Surgical Treatment Of Carcinoid and Other Gut Neuroendocrinementioning

confidence: 99%

Neuroendocrine tumours.

Barakat¹,

Meeran²,

Bloom³

2004

Endocr Relat Cancer

204

111

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Neuroendocrine tumours are a heterogeneous group including, for example, carcinoid, gastroenteropancreatic neuroendocrine tumours, pituitary tumours, medullary carcinoma of the thyroid and phaeochromocytomas. They have attracted much attention in recent years, both because they are relatively easy to palliate and because they have indicated the chronic effect of the particular hormone elevated. As neuroendocrine phenotypes became better understood, the definition of neuroendocrine cells changed and is now accepted as referring to cells with neurotransmitter, neuromodulator or neuropeptide hormone production, dense-core secretory granules, and the absence of axons and synapses. Neuroendocrine markers, particularly chromogranin A, are invaluable diagnostically. Study of several neuroendocrine tumours has revealed a genetic etiology, and techniques such as genetic screening have allowed risk stratification and prevention of morbidity in patients carrying the particular mutation. Pharmacological therapy for these often slow-growing tumours, e.g. with somatostatin analogues, has dramatically improved symptom control, and radiolabelled somatostatin analogues offer targeted therapy for metastatic or inoperable disease. In this review, the diagnosis and management of patients with carcinoid, gut neuroendocrine tumours, multiple endocrine neoplasia types 1 and 2, and isolated phaeochromocytoma are evaluated.

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“…Moreover, the usually inert growth of NETs and their long-term natural history make even more difficult to assess the real effectiveness of hepatic surgical approach on their overall survival. Furthermore, it is well known that in most patients, neuroendocrine liver metastases recur after hepatic resection in up to 70-94% of cases at 5 years [21,24,25,33,[37][38][39], the liver is the most common site of progression of disease (69%) [35], and data on repeat liver directed surgery for recurrent disease have been extremely limited and controversial [36]. In particular, in a study of Saxena and colleagues, most patients with hepatic metastases from NETs experienced treatment failure after liver resection.…”

Section: Liver Metastases From Neuroendocrine Tumorsmentioning

confidence: 99%

Surgical Indications, Timing, and Strategy in Non-colorectal Liver Metastases

Uzzau¹,

Bertozzi²,

Londero³

et al. 2015

Recent Advances in Liver Diseases and Surgery

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Taking into consideration all primary solid tumors, the liver represents the most common site involved in distant metastasization, also due to its important blood reception from the majority of digestive organs. Despite the abundant literature and guidelines about colorectal liver metastases, there is still great debate about the treatment strategy in the case of non-colorectal ones. Therefore, in this chapter, we reviewed the treatment strategy and surgical indications for the most frequent non-colorectal liver metastases. In the case of neuroendocrine hepatic secondaries, the literature suggests that surgery should be always considered for patients with resectable hepatic disease, as this treatment results more likely to offer the best long-term outcome. For what concerns liver metastases from gastric cancer, surgical approach should always be undertaken if indications are appropriate, after a multidisciplinary discussion to plan an adequate multidisciplinary adjuvant treatment, a proper patient selection, and the exclusion of additional secondary tumors or extrahepatic metastases. Taking into consideration liver secondaries from breast cancer and their chemosensitivity, in the absence of brain and lung lesions, it can be considered a space for liver surgery, especially in the case of single lesions or a maximum of two lesions with dimensions within 3 cm. However, as the number of cancer survivors is progressively increasing and, with it, the number of patients affected by non-colorectal liver metastases, further randomized controlled trials are required in order to better define the benefit of hepatic surgery in these kinds of patients.

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Indications and results of liver resection and hepatic chemoembolization for metastatic gastrointestinal neuroendocrine tumors

Cited by 207 publications

References 15 publications

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

GEP–NETS UPDATE: A review on surgery of gastro-entero-pancreatic neuroendocrine tumors

Neuroendocrine tumours.

Surgical Indications, Timing, and Strategy in Non-colorectal Liver Metastases

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