The Landmark Series: Neuroendocrine Tumor Liver Metastases

Ann Surg Oncol. 2020 Sep;27(9):3270-3280. doi: 10.1245/s10434-020-08787-x. Epub 2020 Jul 6.

Abstract

Background: Neuroendocrine tumors are becoming increasingly prevalent, with many patients presenting with or developing metastatic disease to the liver.

Methods: In this landmark series paper, we highlight the critical studies that have defined the surgical management of neuroendocrine tumor liver metastases, as well as several randomized control trials which have investigated strategies for systemic control of metastatic disease.

Results: Liver-directed surgical approaches and locally ablative procedures are recommended for patients with limited, resectable, and in some cases, nonresectable tumor burden. Angiographic liver-directed techniques, such as transarterial embolization, chemoembolization, and radioembolization, offer another approach for management in patients with liver-predominant disease. Peptide receptor radionuclide therapy is a promising therapy for patients with hepatic and/or extrahepatic metastases. Various systemic medical therapies are also available as adjunct or definitive therapy for patients with metastatic disease.

Conclusions: This article reviews current data regarding management of neuroendocrine liver metastases and highlights areas for future study.

Keywords: Liver debulking; Liver metastases; Neuroendocrine; PRRT.

Publication types

  • Review

MeSH terms

  • Chemoembolization, Therapeutic
  • Humans
  • Liver Neoplasms* / secondary
  • Liver Neoplasms* / therapy
  • Neuroendocrine Tumors* / pathology
  • Neuroendocrine Tumors* / therapy
  • Radioisotopes / therapeutic use
  • Randomized Controlled Trials as Topic
  • Tumor Burden

Substances

  • Radioisotopes