The surgical management of neuroendocrine tumour hepatic metastases

Peptide Receptor Radionuclide Therapy Outcomes in a North American Cohort With Metastatic Well-Differentiated Neuroendocrine Tumors

“…The current treatment options for metastatic neuroendocrine tumors include surgical resection of both the primary tumor and metastatic lesions in those patients who have resectable tumors. 3,4 For patients with liver-dominant disease, liver directed therapy such as microwave or radiofrequency ablation and hepatic artery embolization can be utilized. 5 Options for systemic therapy include biotherapy with somatostatin analogues or interferons, targeted therapy with agents such as inhibitors of the mammalian target of rapamycin (mTOR) pathway and kinase inhibitors, cytotoxic chemotherapy, and peptide receptor radionuclide therapy (PRRT).…”

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“…2 On the other hand, surgery is feasible only in fewer than 20% of cases for the bilobar involvement of the liver parenchyma at diagnosis 3 and is generally indicated only if 90% of the tumor mass can be removed. 4,5 In view of the small percentage of patients eligible for resection, considering that the overall 5-year survival rate in case of untreated liver metastases from NET is approximately 30% to 40%, 6 liver transplant can represent the only curative treatment for patients affected by NET bilobar liver metastases.…”

“…[1][2][3][4][5][6][7] We performed a literature review and found 32 articles, from 1989 to 2014 (Table 2), analyzing patient outcomes after liver transplant for NET liver metastases: data on approximately 1188 patients have been collected worldwide. Considering the lack of stringent generally adopted pretransplant selection criteria and of uniform follow-up protocols, which hamper critical assessment of the published results, the 5-year survival rate of liver transplant recipients for neuroendocrine tumors ranges from 0% to 90% (median 50%), resulting in a recurrence of the carcinoid tumors-the main cause of death.…”

Treatment of Neuroendocrine Tumors (NETs) Using Somatostatin Analogs: Current View, Clinical Achievements and Future Perspectives

“…Initially, surgery is the established treatment and has been used for a long time to remove NETs and prolong survival rate in patients (Kaltsas, et al, 2004;Ha, et al, 2012;Walter, et al, 2012). This treatment has also been used in patients with liver metastasis which arises from carcinoid tumors (Pathak, et al, 2013;Nave, et al, 2001). A study showed that surgery for cytoreduction of NET metastasis has been associated with the duration of survival, for instance Mayo and colleagues reported that a 5-year survival and 10-year survival of 74% and 51% respectively, were achieved by the patients after liver-directed surgery for metastatic NETs (Mayo, et al, 2010).…”