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

Abstract:

: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.

journal_name

Semin Oncol

journal_title

Seminars in oncology

authors

Keutgen XM,Schadde E,Pommier RF,Halfdanarson TR,Howe JR,Kebebew E

doi

10.1053/j.seminoncol.2018.07.002

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

232-235

issue

4

eissn

0093-7754

issn

1532-8708

pii

S0093-7754(18)30050-2

journal_volume

45

pub_type

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