Partial hepatic resections for metastatic neuroendocrine tumors: perioperative outcomes

Kinney, Michelle A.O.; Nagorney, David M.; Clark, Daniel F.; O'Brien, Travis; Turner, Jonathan D.; Marienau, Mary E. Shirk; Schroeder, Darrell R.; Martin, David P.

doi:10.1016/j.jclinane.2018.08.005

Cited by 16 publications

(18 citation statements)

References 18 publications

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“…Other reports on the outcome of prophylactic octreotide were published in 2018 [42] and 2019 [12]. Kinney et al retrospectively evaluated 169 patients undergoing partial hepatic resection for metastatic NET between 1997 and 2015, and 77% (130/169) of patients preoperatively received 500 µg of subcutaneous octreotide.…”

Section: Octreotidementioning

confidence: 99%

Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency

Bardasi

Benatti

Luppi

et al. 2022

Cancers

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Carcinoid Crisis represents a rare and extremely dangerous manifestation that can occur in patients with Neuroendocrine Tumors (NETs). It is characterized by a sudden onset of hemodynamic instability, sometimes associated with the classical symptoms of carcinoid syndrome, such as bronchospasm and flushing. Carcinoid Crisis seems to be caused by a massive release of vasoactive substances, typically produced by neuroendocrine cells, and can emerge after abdominal procedures, but also spontaneously in rare instances. To date, there are no empirically derived guidelines for the management of this cancer-related medical emergency, and the available evidence essentially comes from single-case reports or dated small retrospective series. A transfer to the Intensive Care Unit may be necessary during the acute setting, when the severe hypotension becomes unresponsive to standard practices, such as volemic filling and the infusion of vasopressor therapy. The only effective strategy is represented by prevention. The administration of octreotide, anxiolytic and antihistaminic agents represents the current treatment approach to avoid hormone release and prevent major complications. However, no standard protocols are available, resulting in great variability in terms of schedules, doses, ways of administration and timing of prophylactic treatments.

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Section: Octreotidementioning

confidence: 99%

Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency

Bardasi

Benatti

Luppi

et al. 2022

Cancers

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“…Even if octreotide is the treatment of choice for carcinoid crisis according to its efficacy in carcinoid syndrome, data on its value for both managing and preventing the crisis are still scarce and conflicting [50][51][52][53][54][55][56]. All of the existing data are based on retrospective studies which used heterogenous definitions of carcinoid crisis, primary tumor origins, stages of disease, and octreotide regimens.…”

Section: Prevention and Management Of The Carcinoid Crisismentioning

confidence: 99%

“…In 2001, Kinney et al published the first and only study with a control group: they reported no complications during surgery in patients treated with octreotide (0/45, 0%) preoperatively, unlike those who did not receive any octreotide (7/67, 10%) [53]. The other publications, without any control group, described a low rate of carcinoid crisis (range from 0% to 3.4%) with the systematic use of octreotide regimen on the one hand, and a high rate of carcinoid crisis (range from 24% to 32%) despite the systematic use of octreotide regimen [50][51][52][54][55][56] on the other hand. Whatever the efficacy of octreotide regarding carcinoid crisis, it does not seem deleterious, as no increased rate of anastomotic leakage has been reported despite the octreotide-induced decrease of visceral perfusion.…”

Section: Prevention and Management Of The Carcinoid Crisismentioning

confidence: 99%

Surgery and Perioperative Management in Small Intestinal Neuroendocrine Tumors

Deguelte¹,

Perrier²,

Hammoutene³

et al. 2020

JCM

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Small-intestinal neuroendocrine tumors (SI-NETs) are the most prevalent small bowel neoplasms with an increasing frequency. In the multimodal management of SI-NETs, surgery plays a key role, either in curative intent, even if R0 resection is feasible in only 20% of patients due to advanced stage at diagnosis, or palliative intent. Surgeons must be informed about the specific surgical management of SI-NETs according to their hormonal secretion, their usual dissemination at the time of diagnosis and the need for bowel-preserving surgery to avoid short bowel syndrome. The aim of this paper is to review the surgical indications and techniques, and perioperative and postoperative management of SI-NETs.

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“…Kinney et al published the perioperative results of 169 subjects after partial hepatic resection due to metastatic NETs between 1997 and 2015 at Mayo Clinic Rochester. 54 The most common adverse events were sustained tachycardia (8.9%), hypotension (5.3%), flushing (0.6%), cardiac conduction abnormalities (0.6%) and acidosis with pH < 7.2 (0.6%). No cases of carcinoid crisis were 36 Ruszniewski et al 37 Vinik et al (ElECT trial) 38 Telotristat ethyl Kulke et al 39 Pavel et al 40 Kulke et al 41 Pavel et al (TElECaST trial) 42 Peptide receptor radionuclide therapy: 90 y-edotreotide 177 lu-Dotatate…”

Section: Non-cardiac Interventionmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Carcinoid Heart Disease: How to Diagnose and Treat in 2020?

Bober

Saracyn

Kołodziej

et al. 2020

Clin Med Insights Cardiol

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Neuroendocrine tumors (NETs, originally termed “carcinoids”) create a relatively rare group of neoplasms with an approximate incidence rate of 2.5 to 5 cases per 100 000 persons. Roughly 30% to 40% of subjects with NETs develop carcinoid syndrome (CS), and 20% to 50% of subjects with CS are diagnosed with carcinoid heart disease (CaHD). The long-standing exposure to high serum serotonin concentration is one of the crucial factors in CaHD development. White plaque-like deposits on the endocardial surface of heart structures with valve leaflets and subvalvular apparatus thickening (fused and shortened chordae; thickened papillary muscles) are characteristic for CaHD. NT pro-BNP and 5-hydroxyindoleacetic acid are the 2 most useful screening markers. Long-acting somatostatin analogs are the standard of care in symptoms control. They are also the first-line treatment for tumor control in subjects with a metastatic somatostatin receptor avid disease. In cases refractory to somatostatin analogs, several options are available. We can increase a somatostatin analog to off-label doses, add telotristat ethyl or administer peptide receptor radionuclide therapy. Cardiac surgery, which mainly involves valve replacement, is presently the most efficient strategy in subjects with advanced CaHD and can relieve unmanageable symptoms or be partly responsible for better prognosis.

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Partial hepatic resections for metastatic neuroendocrine tumors: perioperative outcomes

Cited by 16 publications

References 18 publications

Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency

Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency

Surgery and Perioperative Management in Small Intestinal Neuroendocrine Tumors

Carcinoid Heart Disease: How to Diagnose and Treat in 2020?

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