Orthotopic liver or multivisceral transplantation as treatment of metastatic neuroendocrine tumors.
Liver transplantation can be a therapeutic option for individual patients with neuroendocrine tumors metastatic only to the liver. In this consecutive series of 15 patients (5 multivisceral and 10 orthotopic liver transplantations) with well-differentiated carcinoids, or endocrine pancreatic tumors, we allowed higher proliferation rate (Ki67 <10%), large tumor burden, and higher age than previous studies. Liver transplantation offered good relief of symptoms, long disease-free intervals, and potential cure in individual patients. The survival of grafts and patients compared well with transplantation for benign disease. The overall 5-year survival was 90%. The recurrence-free survival of both multivisceral and liver transplantation related to the time after transplantation (about 20% at 5 years) despite inclusion of patients with higher risk. In conclusion, the critical prognosticators for long-term outcome still remain to be defined. The experience with multivisceral transplantation for patients with endocrine tumors of the pancreatic head is still limited.
Olausson
Michael
M
Sahlgrenska Transplant Institute, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden.
Friman
Styrbjörn
S
Herlenius
Gustaf
G
Cahlin
Christian
C
Nilsson
Ola
O
Jansson
Svante
S
Wängberg
Bo
B
Ahlman
Håkan
H
D000328:Adult; D004386:Duodenum / Q000637:transplantation; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D018358:Neuroendocrine Tumors / Q000556:secondary* / Q000601:surgery*; D016377:Organ Transplantation; D016035:Pancreas Transplantation; D010190:Pancreatic Neoplasms / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D013270:Stomach / Q000637:transplantation; D015996:Survival Rate; D016896:Treatment Outcome