Resection of the primary pancreatic neuroendocrine tumor in patients with unresectable liver metastases: Possible indications for a multimodal approach

Bertani, Emilio; Fazio, Nicola; Botteri, Edoardo; Chiappa, Antonio; Falconi, Massimo; Grana, Chiara Maria; Bodei, Lisa; Papis, Davide; Spada, Francesca; Bazolli, Barbara; Andreoni, Bruno

doi:10.1016/j.surg.2013.12.024

Cited by 72 publications

(57 citation statements)

References 19 publications

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“…Liver tumour burden is an important criterion for the management of neuroendocrine liver metastases, both for prognosis and treatment (4, 6, 9, 15, 16). …”

Section: Discussionmentioning

confidence: 99%

“…The clinical relevance of these classes has been confirmed in many studies. Hentic and coworkers have shown that a significant liver tumour burden defined as more than 25% was an independent predictor of poorer survival, whereas Bertani and coworkers showed that a liver tumour burden of less than 25% was an important factor for improved survival (4, 15). Rincke and coworkers showed that the antiproliferative effect of somatostatin analogues was greater in patients with a low (≤10%) liver tumour burden, and Palazzo and coworkers found that a low-to-moderate (≤25%) liver tumour burden was predictive of tumour stability under somatostatin analogue therapy, whereas Caplin and coworkers found an antiproliferative effect of lanreotide in patient with larger hepatic tumour volumes (6, 16).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is visual radiological evaluation of liver tumour burden in patients with neuroendocrine tumours reproducible?

Zappa

Hentic²,

Vullierme³

et al. 2017

Endocrine Connections

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BackgroundVisual semi-quantitative assessment of liver tumour burden for neuroendocrine tumour liver metastases is often used in patient management and outcome. However, published data on the reproducibility of these evaluations are lacking.ObjectiveThe aim of this study was to evaluate the interobserver and intraobserver agreement of a visual semi-quantitative assessment of liver tumour burden using CT scan.MethodsFifty consecutive patients (24 men and 26 women, mean aged 54 years) were retrospectively reviewed by four readers (two senior radiologists, one junior radiologist and one gastroenterologist) who assessed the liver tumour burden based on a visual semi-quantitative method with four classes (0–10, 11–25, 26–50 and ≥50%). Interobserver and intraobserver agreement were assessed by weighted kappa coefficient and percentage of agreement. The intraclass correlation was calculated.ResultsAgreement among the four observers for the evaluation of liver tumour burden was substantial, ranging from 0.62 to 0.73 (P < 0.0001). The intraclass coefficient was 0.977 (P < 0.0001). Intraobserver agreement was 0.78 and ICC was 0.97.ConclusionReproducibility of the visual semi-quantitative evaluation of liver tumour burden is good and is independent of the level of experience of the readers. We therefore suggest that clinical studies in patients with neuroendocrine liver metastases use this method to categorise liver tumour burden.

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“…Liver tumour burden is an important criterion for the management of neuroendocrine liver metastases, both for prognosis and treatment (4, 6, 9, 15, 16). …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is visual radiological evaluation of liver tumour burden in patients with neuroendocrine tumours reproducible?

Zappa

Hentic²,

Vullierme³

et al. 2017

Endocrine Connections

View full text Add to dashboard Cite

show abstract

“…We found that the role of primary tumor resection in the presence of unresectable liver metastasis in PNETs was also unclear. Several studies did show a survival benefit for primary tumor resection among PNETs patients, and the difference between resected and unresected group was almost as evident as the MNETS [20, 21]. However, weaker recommendation was made for primary tumor resection for PNETs compared with gastrointestinal NETs, arguing that PNETs have worse prognosis and more operation complications [9, 22].…”

Section: Discussionmentioning

confidence: 99%

Systematic review of resecting primary tumor in MNETs patients with unresectable liver metastases

Guo

Zhang

et al. 2016

Oncotarget

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BackgroundTreatment for midgut neuroendocrine tumor patients with unresectable liver metastasis has long been a controversial issue. This system review aims to summarize existing evidence concerning the value of primary tumor resection in this group of patients.Results8 cohort studies were identified for qualitative analysis. None of them strictly met with the inclusion criteria and meta-analysis was impossible. There was a tendency towards better overall survival for the primary tumor resected group in all 8 studies, in which 6 demonstrated significant difference. Progression free survival to liver disease was prolonged and less patients died of liver failure in the resected group.MethodsMEDLINE, EMBASE and CENTRAL were searched until 2016/7/4 for relevant studies, with primary outcome being overall survival, and secondary outcome being progression free survival, cause of death and symptom relief.ConclusionsCurrent evidence supports resection of primary tumor for midgut neuroendocrine tumor patients with liver metastases, but randomized controlled trials are required to reach a final conclusion.

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“…Several previous reports have demonstrated that, in patients with PNETs and unresectable liver or other distant metastases, resection of the primary tumor was associated with greater overall survival. 12,13 This survival advantage may be related to prevent life-threatening and obstructive complications, bleeding, acute pancreatitis, jaundice, or gastric obstruction.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Resection for Metastatic Neuroendocrine Cancer in Patients with Bone Metastases

et al. 2016

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Resection of the primary pancreatic neuroendocrine tumor in patients with unresectable liver metastases: Possible indications for a multimodal approach

Cited by 72 publications

References 19 publications

Is visual radiological evaluation of liver tumour burden in patients with neuroendocrine tumours reproducible?

Is visual radiological evaluation of liver tumour burden in patients with neuroendocrine tumours reproducible?

Systematic review of resecting primary tumor in MNETs patients with unresectable liver metastases

Hepatic Resection for Metastatic Neuroendocrine Cancer in Patients with Bone Metastases

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