title: Long term results of hepatic resection or orthotopic liver transplantation in patients with liver metastases from gastrointestinal neuroendocrine tumors.
abstract: Hepatic metastases are one of the most important prognostic factors for survival among patients affected by gastrointestinal neuroendocrine tumors (NETs). The present study aims to evaluate the impact of surgery, including hepatic resection or orthotopic liver transplantation (OLT), on the outcome of patients affected by hepatic metastases from NETs, in terms of overall survival (OS). In this multicentric retrospective study, data was collected on 26 patients, who underwent surgery for hepatic metastases from NETs in two Italian University Clinics between January 1990 and December 2012; of which, 22 patients underwent hepatic resective surgery and 4 patients OLT. Hepatic metastases were synchronous in the 53.8% of cases and metachronous in the 46.2% of cases. The median number of resected hepatic metastases was 3. Surgical radicalness (R0) was reached in the 84.6% of cases. In total, 57.7% of patients had a recurrence, 66.7% of which were intra- and 33.3% extra-hepatic. The OS of patients that underwent hepatic resections and OLT was 44.9% [95% confidence interval (CI95), 26.0-77.7%] and 50% (CI95, 12.5-100.0%) at 5 years, respectively. Although the data regarding the survival of patients receiving surgery for hepatic metastases from NETs are encouraging, randomized clinical trials are necessary to more adequately evaluate the effect of surgery on survival of this group of patients.
authors.affiliation: Department of Surgery, University of Udine - DISM - DSMB, 'Santa Maria della Misericordia' University Hospital, I-33100 Udine, Italy.
authors.forename: Enrico Maria
authors.initials: EM
authors.lastname: Pasqual
authors.affiliation: Department of Surgery, University of Udine - DISM - DSMB, 'Santa Maria della Misericordia' University Hospital, I-33100 Udine, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Bertozzi
authors.affiliation: Unit of Obstetrics and Gynecology, 'S. Polo' Hospital, I-34074 Monfalcone, Italy.
authors.forename: Ambrogio P
authors.initials: AP
authors.lastname: Londero
authors.affiliation: Department of Surgery, University of Udine - DISM - DSMB, 'Santa Maria della Misericordia' University Hospital, I-33100 Udine, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bacchetti
authors.affiliation: Department of Surgery, University of Udine - DISM - DSMB, 'Santa Maria della Misericordia' University Hospital, I-33100 Udine, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Lorenzin
authors.affiliation: Department of Anaesthesiology, University of Perugia, I-06123 Perugia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Pasqualucci
authors.affiliation: Department of Surgery, Marche Polytechnic University, 'Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi' University Hospital, I-60123 Ancona, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Moccheggiani
authors.affiliation: Department of Surgery, Marche Polytechnic University, 'Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi' University Hospital, I-60123 Ancona, Italy.
authors.forename: Alen
authors.initials: A
authors.lastname: Federici
authors.affiliation: Department of Surgery, Marche Polytechnic University, 'Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi' University Hospital, I-60123 Ancona, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Vivaverlli
authors.affiliation: Department of Surgery, University of Udine - DISM - DSMB, 'Santa Maria della Misericordia' University Hospital, I-33100 Udine, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Risaliti
keywords: gastroenteropancreatic neuroendocrine tumors; hepatic resection; liver metastases; orthotopic liver transplantation; overall survival