Liver Transplant for Metastatic Neuroendocrine Tumors: A Single-Center Report

Sampaio, Raquel Lima; Coelho, Gustavo; Quidute, Ana Rosa Pinto; Filho, Duílio Reis da Rocha; Soares, Carlos Eduardo Lopes; Garcia, José Huygens Parente

doi:10.1590/0102-672020230032e1750

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…Arterial embolization, radioablation, and liver transplantation are indicated when tumors are unresectable. Chemotherapy should be considered in cases of extrahepatic metastases or recurrent symptomatic disease 35 , 36 . In this study, cases treated with subtotal gastrectomy and Roux-en-Y reconstruction with lymphadenectomy predominated.…”

Section: Discussionmentioning

confidence: 99%

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Gastric Neuroendocrine Tumor: When Surgical Treatment Is Indicated?

Assis Filho,

Tercioti Junior,

Andreollo

et al. 2023

ABCD, arq. bras. cir. dig.

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BACKGROUND: Gastric neuroendocrine tumors are a heterogeneous group of neoplasms that produce bioactive substances. Their treatment varies according to staging and classification, using endoscopic techniques, open surgery, chemotherapy, radiotherapy, and drugs analogous to somatostatin. AIMS: To identify and review cases of gastric neuroendocrine neoplasia submitted to surgical treatment. METHODS: Review of surgically treated patients from 1983 to 2018. RESULTS: Fifteen patients were included, predominantly female (73.33%), with a mean age of 55.93 years. The most common symptom was epigastric pain (93.3%), and the mean time of symptom onset was 10.07 months. The preoperative upper digestive endoscopy (UDE) indicated a predominance of cases with 0 to 1 lesion (60%), sizing ≥1.5 cm (40%), located in the gastric antrum (53.33%), with ulceration (60%), and Borrmann III (33.33%) classification. The assessment of the surgical specimen indicated a predominance of invasive neuroendocrine tumors (60%), with angiolymphatic invasion in most cases (80%). Immunohistochemistry for chromogranin A was positive in 60% of cases and for synaptophysin in 66.7%, with a predominant Ki-67 index between 0 and 2%. Metastasis was observed in 20% of patients. The surgical procedure most performed was subtotal gastrectomy with Roux-en-Y reconstruction (53.3%). Tumor recurrence occurred in 20% of cases and a new treatment was required in 26.67%. CONCLUSIONS: Gastric neuroendocrine tumors have a low incidence in the general population, and surgical treatment is indicated for advanced lesions. The study of its management gains importance in view of the specificities of each case and the need for adequate conduct to prevent recurrences and complications.

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Section: Discussionmentioning

confidence: 99%

“…In addition to the characteristics already described, type IV tumors differ from the other subtypes, because they are not associated with cells similar to the enterochromaffin cells. They derive from other endocrine cells, which secrete hormones such as serotonin, gastrin and adrenocorticotropic hormone 26 , 35 .…”

Section: Introductionmentioning

confidence: 99%

Gastric Neuroendocrine Tumor: When Surgical Treatment Is Indicated?

Assis Filho,

Tercioti Junior,

Andreollo

et al. 2023

ABCD, arq. bras. cir. dig.

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“…In Brazil, according to legislation, LT from cadaveric donor for liver metastasis is prohibited, except for neuroendocrine tumors 16 . Conditioned by the risk to the donor, LDLT is the only modality to be offered to patients with liver colorectal metastasis.…”

Section: Discussionmentioning

confidence: 99%

An Experience on Living Donor Liver Transplantation for Colorectal Liver Metastasis in South America: A New Era in Transplant Oncology

Fernandes,

Souza,

Braga

et al. 2023

ABCD, arq. bras. cir. dig.

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BACKGROUND: Complete surgical resection is the treatment of choice for patients with liver metastases, but in some patients, it is not possible to obtain a complete R0 resection. Moreover, the recurrence rate is up to 75% after three years. After the experience of the Oslo group with cadaveric liver transplant, some centers are starting their experience with liver transplant for colorectal liver metastasis. AIMS: To present our initial experience with living donor liver transplant for colorectal liver metastasis. METHODS: From 2019 to 2022, four liver transplants were performed in patients with colorectal liver metastases according to the Oslo criteria. RESULTS: Four patients underwent living donor liver transplants, male/female ratio was 3:1, mean age 52.5 (42–68 years). All patients were included in Oslo criteria for liver transplant. Two patients had already been submitted to liver resection. The decision for liver transplant occurred after discussion with a multidisciplinary team. Three patients recurred after the procedure and the patient number 3 died after chemotherapy. CONCLUSIONS: Living donor liver transplant is a viable treatment option for colorectal liver metastasis in Brazil, due to a shortage of donors.

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Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence

Lai,

Coppola,

Mrzljak

et al. 2024

Biomedicines

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Background/Objectives: Neuroendocrine neoplasms (NEN) are heterogeneous entities. Despite considerable advancement in the field, almost 50% of patients have metastatic disease, when liver transplantation (LT) is one of the possible treatments offering a cure in well-selected patients. Methods: The present study aims to systematically review all the literature from 2000 onwards on using LT for patients with NEN-LM, with particular attention to the risk factors of death and recurrence. Results: LT offers 5-year OS ranging from 52 to 74% and 5-year TFS rates ranging from 39 to 62%, with even better results published from 2009 onwards. The main risk factors for patient deaths are related to unfavorable primary tumor pathology, higher liver involvement, and simultaneous LT and primary resection. Similarly, recurrence is higher related to poor tumor grade and differentiation, and in the case of an older recipient age. Conclusions: Applying uniform criteria and a more in-depth understanding of the relevant prognostic factors contribute to a better selection of candidates for curative LT due to NEN metastases. LT for unresectable or liver-restricted NENs has a relevant place in the treatment algorithm and has achieved excellent results in recent decades, but more international efforts are needed to further improve outcomes.

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Liver Transplant for Metastatic Neuroendocrine Tumors: A Single-Center Report

Cited by 3 publications

References 9 publications

Gastric Neuroendocrine Tumor: When Surgical Treatment Is Indicated?

Gastric Neuroendocrine Tumor: When Surgical Treatment Is Indicated?

An Experience on Living Donor Liver Transplantation for Colorectal Liver Metastasis in South America: A New Era in Transplant Oncology

Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence

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