Surgical strategy for neuroendocrine liver metastases

Abstract

Introduction: There are no established strategies for the surgical management of neuroendocrine liver metastases. Surgical treatment options include liver resection, liver transplantation and debulking hepatectomy. Other liver-directed therapies include local ablation and transarterial embolization. Aim: In the present review, we discuss the outcomes of the different surgical treatment modalities for neuroendocrine liver metastases. Patients and methods: A review of the published literature on the surgical management of neuroendocrine liver metastases was undertaken. Results: Liver resection is the curative treatment of choice for patients with grade 1 or 2 liver metastases without concurrent extra-hepatic disease. Liver transplantation is another potentially curative therapy. Debulking hepatectomy might be indicated for symptomatic neuroendocrine liver disease, whereas liver -directed local ablative and trans-arterial treatments should be considered for patients not suitable for liver resection or transplantation. Conclusions: Hepatectomy and liver transplanatation should be offered to patients with resectable neuroendocrine liver metastases in the absence of extrahepatic metastases. 63Neuroendocrine liver metastases multidisciplinary surgical-oncology team to ensure the selection of the optimal treatment strategy.

Clinicopathological Data and Treatment Modalities for Pancreatic Somatostatinomas

“…However, the treatment strategy is challenging and difficult to be established due to the rarity of liver metastases. A recent large review on surgical management of neuroendocrine liver metastases demonstrated similar outcomes and encouraged hepatectomy when technically feasible (22). Similar results were also presented in a review of 116 studies, which recommended metastasectomy as the potentially curative therapeutic option for patients with metastatic NET if technically feasible (23).…”