title: Management of patients with hepatic metastases from neuroendocrine tumors.
abstract: Neuroendocrine tumors have a disposition toward metastasis to the liver. A range of treatment modalities for neuroendocrine liver metastases is available in the clinical arena, the indications for which depend on tumor characteristics such as patterns of metastasis, tumor grade, and anatomical origin. The complete surgical resection of liver deposits represents the only option with the intent to cure and is the gold standard approach, whereas cytoreductive resection (debulking) presents another surgical option aiming to ameliorate the symptoms and prolong survival. Liver transplantation is generally an accepted option for highly selected patients. For patients ineligible for radical surgery, liver-directed therapies-transarterial embolization/chemoembolization, selective internal radiotherapy, and local tumor ablation-present alternative strategies. Systemic therapies include peptide receptor radiotherapy, somatostatin analogues, cytotoxic chemotherapeutics, and novel molecularly targeted drugs. However, despite the variety of treatments available, there exists little evidence to guide optimal clinical practice with currently available data predominantly retrospective in nature. In this review, we discuss the diagnostic procedures that influence the trajectory of treatment of patients with neuroendocrine liver metastases before critically appraising the evidence pertaining to these therapeutic strategies.
authors: Ashley Kieran
authors: AK
authors: Clift
authors: Prof. Andrea Frilling, Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, DuCane Road, London W12 0NN, United Kingdom, T: 00442083833210, F: 00442083833963, a.frilling@imperial.ac.uk.
authors: Andrea
authors: A
authors: Frilling
mesh_terms: D055011:Ablation Techniques; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016461:Chemoembolization, Therapeutic; D065426:Cytoreduction Surgical Procedures; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000556:secondary / Q000628:therapy*; D016031:Liver Transplantation; D058990:Molecular Targeted Therapy; D018358:Neuroendocrine Tumors / Q000473:pathology* / Q000556:secondary / Q000628:therapy*; D019275:Radiopharmaceuticals / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals