Liver resection versus other treatments for neuroendocrine tumours in patients with resectable liver metastases.
BACKGROUND
Neuroendocrine tumours are tumours of cells, which possess secretory granules and originate from the neuroectoderm. While liver resection is generally advocated in patients with resectable liver metastases, recent studies have shown good survival in patients with disseminated neuroendocrine tumours who underwent thermal ablation using radiofrequency.


OBJECTIVE
To determine the benefits and harms of liver resection versus other treatments in patients with resectable liver metastases from gastro-entero-pancreatic neuroendocrine tumours.


METHODS
We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded and LILACS until July 2008 for identifying the randomised trials.


METHODS
We considered only randomised clinical trials (irrespective of language, blinding, or publication status) comparing liver resection (alone or in combination with radiofrequency ablation or cryoablation) versus other interventions (chemotherapy, hormonotherapy, or immunotherapy) and those comparing liver resection and thermal ablation (radiofrequency ablation or cryoablation) in patients with resectable liver metastases from neuroendocrine tumours for the review.


METHODS
Two authors independently identified trials for inclusion.


RESULTS
We were unable to identify any randomised clinical trial suitable for inclusion in this review. We were also unable to identify any quasi-randomised studies, cohort studies, or case-control studies that could inform meaningfully.


CONCLUSIONS
There is no evidence from randomised clinical trials comparing liver resection versus other treatments in patients with resectable liver metastases from gastro-entero-pancreatic neuroendocrine tumours. Liver resection appears to be the main stay curative treatment for neuroendocrine liver metastases based on non-randomised studies. Further randomised clinical trials comparing liver resection alone or in combination with chemoembolisation or radionuclide therapy are needed. Further randomised clinical trials comparing surgical resection and radiofrequency ablation in selected patients may also be appropriate.
University Department of Surgery, Royal Free Hospital and University College School of Medicine, 9th Floor, Royal Free Hospital, Pond Street, London, UK, NW3 2QG. kurinchi2k@hotmail.com
Kurinchi Selvan
KS
Gurusamy
Rajarajan
R
Ramamoorthy
Dinesh
D
Sharma
Brian R
BR
Davidson
D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D018358:Neuroendocrine Tumors / Q000556:secondary / Q000601:surgery*