Metastatic Neuroendocrine Hepatic Tumors

Musunuru, Sandeepa; Chen, Herbert; Rajpal, Sharad; Stephani, Nicholas; McDermott, John C.; Holen, Kyle D.; Rikkers, Layton F.; Weber, Sharon M.

doi:10.1001/archsurg.141.10.1000

Cited by 139 publications

(80 citation statements)

References 8 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: 99%

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: 99%

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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“…However, unlike other gastrointestinal malignancies, surgical intervention is considerably more effective, and removal of both the metastasis and primary tumour is often considered if technically feasible in patients of excellent performance status, either in a synchronous or staged resection. Various groups have reported impressive 5-year survival rates up to 87% following surgical resection of NET liver metastases (Que et al 1995, Chamberlain et al 2000, Nave et al 2001, Musunuru et al 2006. Unfortunately recurrence is observed in the majority of patients (Cho et al 2008).…”

Section: Surgerymentioning

confidence: 99%

Systemic therapy for neuroendocrine tumours of gastroenteropancreatic origin

Basu¹,

Sirohi²,

Corrie

2010

Endocrine-Related Cancer

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Systemic therapy is one of a number of treatment options routinely used in the management of advanced, unresectable neuroendocrine tumours (NETs). In contrast to many of the other NET treatment modalities, there is at least some evidence base to justify its use. Even so, welldesigned clinical trials are limited, since conducting clinical research in this complex group of rare cancers is challenging. The remit of this review article is to summarise the oncology literature and explain the role of systemic therapy in treating NETs of gastroenteropancreatic origin, identifying benefits and limitations. The molecular biology of NETs is now being unravelled, which affords new opportunities for development of mechanism-driven therapies. The rationale for some of the newer systemic targeted therapies that are showing promise in the clinic is discussed.

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“…Concerning other prognostic parameters for primary NETs and liver metastases, Katz et al demonstrated that the robust presence of tumor-infiltrating lymphocytes is a significant predictor of outcome [44]. Other recent articles confirmed surgical therapy to be the most efficient approach against solitary hepatic metastases [7,8,14,22,23,33,34,40,45,46], with a potential curative resection of liver secondaries can be undertaken in 13.7 to 24.5% of patients with metastatic NETs [47][48][49], and a significant reduction of carcinoid symptoms [43], but the majority of studies focused exclusively on resection rather than combined-modality approaches with ablation or chemotherapy.…”

Section: Liver Metastases From Neuroendocrine Tumorsmentioning

confidence: 99%

“…In fact, metastases are well recognized as being the major cause of death among neoplastic patients, and the prognosis of patients affected by unresectable liver metastases is very poor. However, although once metastatic malignancies were commonly considered as a terminal neoplastic stage, nowadays, many different therapeutical options have been introduced in order to provide a safe and efficient treatment for these kinds of patients and improve both their quantity and quality of life [6][7][8][9].…”

Section: Introductionmentioning

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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Metastatic Neuroendocrine Hepatic Tumors

Cited by 139 publications

References 8 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

Systemic therapy for neuroendocrine tumours of gastroenteropancreatic origin

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

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