Back
Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas: A surgeon's plea to centering attention on the liver.
Journal article

Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas: A surgeon's plea to centering attention on the liver.

  • Keutgen XM Rush University Medical Center, Department of Surgery, Division of Surgical Oncology, Chicago, IL, USA. Electronic address: Xavier_keutgen@rush.edu.
  • Schadde E Rush University Medical Center, Department of Surgery, Division of Surgical Oncology, Chicago, IL, USA; Cantonal Hospital Winterthur, Department of Surgery, Winterthur, Zurich, Switzerland; University of Zurich, Institute of Physiology, Zurich, Switzerland.
  • Pommier RF Oregon Health & Science University, Department of Surgery, Division of Surgical Oncology, Portland, OR, USA.
  • Halfdanarson TR Mayo Clinic, Department of Oncology, Division of Medical Oncology, Rochester, MN, USA.
  • Howe JR University of Iowa, Department of Surgery, Division of Surgical Oncology, Iowa City, IA, USA.
  • Kebebew E Stanford University, Department of Surgery, Division of Surgical Oncology, Stanford, CA, USA.
Show more…
  • 2018-10-16
Published in:
  • Seminars in oncology. - 2018
Liver metastases
Liver resection
Neuroendocrine tumor
Systemic therapy
Cytoreduction Surgical Procedures
Hepatectomy
Humans
Intestinal Neoplasms
Liver Neoplasms
Neuroendocrine Tumors
Pancreatic Neoplasms
Stomach Neoplasms
English Over 50% of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have stage IV disease at presentation and the most likely organ to be affected by metastases is the liver. Hepatic involvement and hepatic tumor burden is a key prognostic factor affecting survival of these patients and 80% eventually die of liver failure due to tumor dissemination within the liver. This commentary explores the efficacy and limitations of systemic treatments in patients with GEP-NETs and liver metastases. Landmark randomized trials using systemic therapies including sandostatin (PROMID), lanreotide (CLARINET), everolimus (RADIANT 3 and 4), sunitinib and Peptide Receptor Radionuclide Therapy (NETTER-1) have not shown efficacy in reducing liver tumor burden in patients with stage IV GEP-NETs with liver metastases as outlined in this review. Although often overlooked, surgical debulking has been associated with a significant survival advantage in large retrospective studies and in our opinion should remain an important therapeutic option for patients with stage IV GEP-NETs and liver metastases.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/47742
Statistics
Document views: 41 File downloads: