Surgical Treatment of Neuroendocrine Liver Metastases

Management of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database wa...

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Main Authors: Ser Yee Lee, Peng Chung Cheow, Jin Yao Teo, London L. P. J. Ooi
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:International Journal of Hepatology
Online Access:http://dx.doi.org/10.1155/2012/146590
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author Ser Yee Lee
Peng Chung Cheow
Jin Yao Teo
London L. P. J. Ooi
author_facet Ser Yee Lee
Peng Chung Cheow
Jin Yao Teo
London L. P. J. Ooi
author_sort Ser Yee Lee
collection DOAJ
description Management of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database was performed from 1995–2010, to collate the current evidence and formulate a sound management algorithm. There are 22 case series with a total of 793 patients who had undergone surgery for NELM. The overall survival ranges from 46–86% at 5 years, 35–79% at 10 years, and the median survival ranges from 52–123 months. After successful cytoreductive surgery, the mean duration of symptom reduction is between 16–26 months, and the 5-year recurrence/progression rate ranges from 59–76%. Five studies evaluated the efficacy of a combination cytoreductive strategy reporting survival rate of ranging from 83% at 3 years to 50% at 10 years. To date, there is no level 1 evidence comparing surgery versus other liver-directed treatment options for NELM. An aggressive surgical approach, including combination with additional liver-directed procedures is recommended as it leads to long-term survival, significant long-term palliation, and a good quality of life. A multidisciplinary approach should be established as the platform for decision making.
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spelling doaj-art-92cd3c63fd0b49608e03ddf5989a46ae2025-08-20T02:09:55ZengWileyInternational Journal of Hepatology2090-34482090-34562012-01-01201210.1155/2012/146590146590Surgical Treatment of Neuroendocrine Liver MetastasesSer Yee Lee0Peng Chung Cheow1Jin Yao Teo2London L. P. J. Ooi3Department of Surgical Oncology, National Cancer Centre, 11 Hospital Drive, 169610, SingaporeDepartment of General Surgery, Singapore General Hospital, Outram Road, 169608, SingaporeDepartment of General Surgery, Singapore General Hospital, Outram Road, 169608, SingaporeDepartment of Surgical Oncology, National Cancer Centre, 11 Hospital Drive, 169610, SingaporeManagement of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database was performed from 1995–2010, to collate the current evidence and formulate a sound management algorithm. There are 22 case series with a total of 793 patients who had undergone surgery for NELM. The overall survival ranges from 46–86% at 5 years, 35–79% at 10 years, and the median survival ranges from 52–123 months. After successful cytoreductive surgery, the mean duration of symptom reduction is between 16–26 months, and the 5-year recurrence/progression rate ranges from 59–76%. Five studies evaluated the efficacy of a combination cytoreductive strategy reporting survival rate of ranging from 83% at 3 years to 50% at 10 years. To date, there is no level 1 evidence comparing surgery versus other liver-directed treatment options for NELM. An aggressive surgical approach, including combination with additional liver-directed procedures is recommended as it leads to long-term survival, significant long-term palliation, and a good quality of life. A multidisciplinary approach should be established as the platform for decision making.http://dx.doi.org/10.1155/2012/146590
spellingShingle Ser Yee Lee
Peng Chung Cheow
Jin Yao Teo
London L. P. J. Ooi
Surgical Treatment of Neuroendocrine Liver Metastases
International Journal of Hepatology
title Surgical Treatment of Neuroendocrine Liver Metastases
title_full Surgical Treatment of Neuroendocrine Liver Metastases
title_fullStr Surgical Treatment of Neuroendocrine Liver Metastases
title_full_unstemmed Surgical Treatment of Neuroendocrine Liver Metastases
title_short Surgical Treatment of Neuroendocrine Liver Metastases
title_sort surgical treatment of neuroendocrine liver metastases
url http://dx.doi.org/10.1155/2012/146590
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