Surgical treatment of primary neuroendocrine tumors of the liver.
Primary neuroendocrine tumor (NET) of the liver is a very rare neoplasm, requiring strict exclusion of possible extrahepatic primary sites for its diagnosis. We have analyzed our clinical experience of eight patients with hepatic primary NET. From January 1997 to December 2006, eight patients with a mean age of 50.4 +/- 9.5 years underwent liver resection for primary hepatic NET. Seven patients underwent preoperative liver biopsies, which correctly diagnosed NET in four. Of the eight patients, six underwent R0 and two underwent R1 resection. Diagnosis of hepatic primary NET was confirmed immunohistochemically and by the absence of extrahepatic primary sites. All tumors were single lesions, of mean size 8.6 +/- 5.7 cm, and all showed positive staining for synaptophysin and chromogranin. During a mean follow-up of 34.0 +/- 39.7 months, three patients died of multiple liver metastases after tumor recurrence, whereas the other five remain alive to date, making the 5-year recurrence rate 40% and the 5-year survival rate 56.3%. Univariate analysis showed that Ki67 proliferative index was a risk factor for tumor recurrence. In conclusion, although primary hepatic NET is very rare, it should be distinguished from other liver neoplasms. The mainstay of treatment is curative liver resection.
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. shwang@amc.seoul.kr
Shin
S
Hwang
Young-Joo
YJ
Lee
Sung-Gyu
SG
Lee
Chan-Wook
CW
Kim
Ki-Hun
KH
Kim
Chul-Soo
CS
Ahn
Ki-Myung
KM
Moon
Kyoung-Hoon
KH
Ko
Kwan-Woo
KW
Kim
Nam-Kyu
NK
Choi
Tae-Yong
TY
Ha
D000328:Adult; D002864:Chromogranins / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006651:Histocytochemistry; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016708:Synaptophysin / Q000032:analysis
D002864:Chromogranins; D016708:Synaptophysin