Neuroendocrine Tumors Metastatic to the Liver

Ajani, Jaffer A.; Carrasco, C. Humberto; Wallace, Sidney

doi:10.1111/j.1749-6632.1994.tb17298.x

Cited by 19 publications

(16 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The contraindications are tumour burden exceeding 50% of the liver volume, portal vein occlusion and hyperbilirubinaemia. Relative contraindications are contrast allergy, coagulopathies, persistent elevation of liver enzymes, extrahepatic tumour dominance and poor performance status [16]. In our experience, also patients with a large tumour volume can undergo embolization with superselective embolizations, well separated in time (2–4 weeks); this can also be done in patients with previous hemihepatectomy and recurrence in the residual liver.…”

Section: Interventional Treatment Modalitiesmentioning

confidence: 99%

See 1 more Smart Citation

Interventional Treatment of the Carcinoid Syndrome

Ahlman¹,

Nilsson

Olausson³

2004

Neuroendocrinology

View full text Add to dashboard Cite

Liver metastases imply a major problem in patients with carcinoid tumours and hormone overproduction. Patients with distant metastases can undergo resection for potential cure or for symptom palliation. In patients with bilobar liver metastases other interventions are at hand, e.g. local ablation or hepatic arterial embolization. In selected cases liver transplantation can be a treatment alternative. Prior to all interventions patients with midgut carcinoids are protected with somatostatin analogues to reduce hormone secretion. Patients with foregut carcinoids may present special problems with life-threatening release of histamine during interventions.

show abstract

Section: Interventional Treatment Modalitiesmentioning

confidence: 99%

“…Ischaemia can be established by several techniques directed against the hepatic artery: ligation, selective embolization, or temporary occlusion. The methods differ in completeness, distribution and duration of ischaemia [16]. …”

Section: Interventional Treatment Modalitiesmentioning

confidence: 99%

Interventional Treatment of the Carcinoid Syndrome

Ahlman¹,

Nilsson

Olausson³

2004

Neuroendocrinology

View full text Add to dashboard Cite

show abstract

“…Contraindications are tumour burden exceeding 50% of the liver volume, occlusion of the portal vein, hyperbilirubinaemia and persistently elevated liver enzymes. Relative contraindications are contrast allergy, coagulopathies, extrahepatic tumour dominance or poor performance status of the patient [30]. In our experience, patients with tumour volumes exceeding 50% can also safely undergo this type of treatment using iterated superselective embolizations well separated in time.…”

Section: Interventional Treatment Of Liver Metastasesmentioning

confidence: 99%

“…Both absorbable and nonabsorbable embolization materials have been used, e.g. gelfoam powder and alcohol-Ivalon particles [30, 33]. The need to maintain an open route for repeat procedures excludes the choice of steel coils in the proximal arterial segment.…”

Section: Interventional Treatment Of Liver Metastasesmentioning

confidence: 99%

“…Embolization may lead to serious complications in individual patients (gallbladder ischaemia, pancreatitis, liver abscess, vascular damage and aneurysm formation, hepatorenal syndrome and hormonal crises). The mortality in the major series is less than 5% [30]. To minimize adverse reactions, several precautions can be undertaken, which include first of all an experienced interventional radiologist, but also the use of coaxial catheter systems for superselective catheterization with low risk of vascular damage, prophylactic use of octreotide, cholecystectomy at the time of primary surgery to eliminate the risk for gallbladder perforation, intravenous hydration and haemodynamic monitoring to reduce the risk for the hepatorenal syndrome [4, 27].…”

Section: Interventional Treatment Of Liver Metastasesmentioning

confidence: 99%

See 1 more Smart Citation

Interventional Treatment of Gastrointestinal Neuroendocrine Tumours

et al. 2000

View full text Add to dashboard Cite

Neuroendocrine (NE) tumours of the gastrointestinal tract (carcinoids and endocrine pancreatic tumours) are rare diseases. In the presence of liver metastases these patients may suffer from disabling symptoms due to hormone overproduction. Patients with localized disease can be resected for cure and also patients with liver metastases can undergo potentially curative tumour resection. However, long-term follow-up of the latter cases indicates frequent recurrence of tumour. Using close biochemical monitoring of tumour markers combined with newer techniques for tumour visualization, these recurrences can often be diagnosed at an early stage so that repeat surgical procedures can be performed. During the last years very active surgery has been recommended for NE tumours, many of which have a relatively slow growth. Even in patients not amenable to curative liver surgery, debulking can be considered if the main tumour burden can be safely excised. The primary aim of this type of treatment is palliation of hormonal symptoms. An important question is whether the aggressive treatment actually prolongs survival. No prospective studies have been performed. Such studies are hampered by the lack of strict surgical programs running over long periods and the relative rarity of NE tumours. Liver transplantation may be another treatment modality in selected cases.

show abstract