[Liver transplantation in the management of unresectable bilateral neuroendocrine metastases].
BACKGROUND
Neuroendocrine tumors are rare neoplasms that present bilateral liver metastases at diagnosis. Because of the good initial results obtained, liver transplantation is considered as a potentially curative treatment.


OBJECTIVE
Present our experience of the use of liver transplantation in the management of unresectable bilateral neuroendocrine metastases.


METHODS
We retrospectively reviewed the medical records of eight patients (four men and four women), with a mean age of 45 years, who underwent liver transplantation due to bilateral neuroendocrine liver metastases between January 1996 and January 2005. The most frequent location of the primary tumor was the pancreas in five patients (one carcinoid, one gastrinoma and three non-functioning tumors). The remaining three tumors were located in the small bowel (two) and in the lung.


RESULTS
Only one patient died due to technical complications related to the transplant, representing a mortality rate for the entire group of 14%. After a median follow-up of 3 years (range: 1 month-6 years), two patients died due to tumoral recurrence at 15 and 17 months, representing a tumoral recurrence rate of 33%. The survival rate at 1 and 3 years was 86% and 57%, respectively.


CONCLUSIONS
Despite the initial promising results obtained with liver transplantation in the management of unresectable neuroendocrine liver metastases, our results indicate that careful patient selection is required. The key to obtaining good results is individualization of the indication for this procedure.
Fernández
Juan Angel
JA
Servicio de Cirugía I, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. jumanjico@yahoo.com
Robles
Ricardo
R
Marín
Caridad
C
Ramírez
María
M
Ramírez
Pablo
P
Sánchez-Bueno
Francisco
F
Luján
Juan
J
Rodríguez
José Manuel
JM
Parrilla
Pascual
P
D000328:Adult; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology*; D012189:Retrospective Studies