[Liver transplantation in neuroendocrine tumors prolongs symptom-free period, might also be a cure].
Several neuroendocrine tumours, such as carcinoids and pancreatic endocrine tumours, may manifest relatively slow tumour growth. The patients may suffer from severe hormonal symptoms, largely due to liver metastases which sometimes are amenable to cytoreductive surgery. If residual tumour after primary tumour resection is multilobar, liver transplantation may be one way to treat hormonal symptoms and possibly prolonging survival. Early long-term outcome of liver transplantation in patients with neuroendocrine tumours suggests prognosis to be more favourable for carcinoids than for endocrine pancreatic tumours. It is suggested that liver transplantation may be appropriate for patients with isolated hepatic tumour disease in the following situations: 1, tumour recurrence after liver surgery for cure; 2, non-resectable liver disease, especially in cases of severe hormonal symptoms; and 3, disease progression after hepatic arterial embolisation and medical therapy. These indications are discussed in the light of three case reports.
Olausson
M
M
Divisionen för kirurgi, Sahlgrenska Universitetssjukhuset, Göteborg.
Friman
S
S
Johanson
V
V
Nilsson
O
O
Wängberg
B
B
Ahlman
H
H
D000328:Adult; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D011379:Prognosis