Management of neuroendocrine tumor liver metastases

Harrelson, Alex; Wang, Rongzhi; Stewart, A. Keith; Ingram, Christopher W.; Gillis, Andrea; Rose, J. Bart; El-Reyes, Bassel; Azmi, Asfar S.; Chen, Herbert

doi:10.1016/j.amjsurg.2023.08.011

Cited by 3 publications

(2 citation statements)

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“…For example, the localized disease is typically more indolent with slow-growing lesions and a good prognosis, with reported overall survival (OS) > 30 years [1]. However, metastasis to the liver carries a poor 5-year survival rate, ranging from approximately 19-38%, and the extent of hepatic tumor burden is a crucial prognostic determinant [9,10]. Approximately two-thirds of NETs occur across the gastroenteropancreatic (GEP-NET) system, which constitutes a more aggressive form associated with a worse prognosis [11].…”

Section: Introductionmentioning

confidence: 99%

“…According to the European Neuroendocrine Tumor Society (ENETS) and the North American Neuroendocrine Society (NANETS), for patients with neuroendocrine disease with liver metastases, surgical resection remains the gold standard in the pursuit of curative intent [12]. However, in recent years, there has been a notable emergence of innovative treatment modalities, which may not aim to achieve a cure, but focus on alleviating symptoms, prolonging survival, and improving quality of life [9,13]. Within the battery of treatment approaches for NELM, non-surgical methods including catheter-driven and percutaneous approaches have emerged as adjuncts or viable alternatives to surgery [14].…”

Section: Introductionmentioning

confidence: 99%

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Liver-Directed Locoregional Therapies for Neuroendocrine Liver Metastases: Recent Advances and Management

Criss,

Makary

2024

Current Oncology

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Neuroendocrine tumors (NETs) are a heterogeneous class of cancers, predominately occurring in the gastroenteropancreatic system, which pose a growing health concern with a significant rise in incidence over the past four decades. Emerging from neuroendocrine cells, these tumors often elicit paraneoplastic syndromes such as carcinoid syndrome, which can manifest as a constellation of symptoms significantly impacting patients’ quality of life. The prognosis of NETs is influenced by their tendency for metastasis, especially in cases involving the liver, where the estimated 5-year survival is between 20 and 40%. Although surgical resection remains the preferred curative option, challenges emerge in cases of neuroendocrine tumors with liver metastasis (NELM) with multifocal lobar involvement, and many patients may not meet the criteria for surgery. Thus, minimally invasive and non-surgical treatments, such as locoregional therapies, have surfaced. Overall, these approaches aim to prioritize symptom relief and aid in overall tumor control. This review examines locoregional therapies, encompassing catheter-driven procedures, ablative techniques, and radioembolization therapies. These interventions play a pivotal role in enhancing progression-free survival and managing hormonal symptoms, contributing to the dynamic landscape of evolving NELM treatment. This review meticulously explores each modality, presenting the current state of the literature on their utilization and efficacy in addressing NELM.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Liver-Directed Locoregional Therapies for Neuroendocrine Liver Metastases: Recent Advances and Management

Criss,

Makary

2024

Current Oncology

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Current Management of Neuroendocrine Tumour Liver Metastases

Sharma,

Muralitharan,

Ramage

et al. 2024

Curr Oncol Rep

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Purpose of review This article aims to illustrate the current state of investigations and management of liver metastases in patients with Neuroendocrine Neoplasms. Neuroendocrine tumours (NETs) are rising in incidence globally and have become the second most prevalent gastrointestinal malignancy in UK and USA. Frequently, patients have metastatic disease at time of presentation. The liver is the most common site of metastases for gastro-enteropancreatic NETs. Characterisation of liver metastases with imaging is important to ensure disease is not under-staged. Recent Findings Magnetic resonance imaging and positron emission tomography are now becoming standard of care for imaging liver metastases. There is an increasing armamentarium of therapies available for management of NETs and loco-regional therapy for liver metastases. The data supporting surgical and loco-regional therapy is reviewed with focus on role of liver transplantation. Summary It is important to use appropriate imaging and classification of NET liver metastases. It is key that decisions regarding approach to treatment is undertaken in a multidisciplinary team and that individualised approaches are considered for management of patients with metastatic NETs.

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