Neuroendocrine hepatic metastatic disease: the surgeon's perspective

Abdom Radiol (NY). 2022 Dec;47(12):4073-4080. doi: 10.1007/s00261-022-03515-3. Epub 2022 Apr 27.

Abstract

Neuroendocrine tumors are a rare subset of tumors that are increasing in incidence over the last 4 decades. These tumors occur along the gastrointestinal tract and bronchopulmonary tree and frequently metastasize. Up to 90% of patients with gastroenteropancreatic neuroendocrine tumors develop liver metastases (NeLM) during their clinical course. The development of NeLM and their appropriate management has a profound impact on patient morbidity and mortality. Workup of NeLM involves biopsy to define tumor grade, cross-sectional imaging to delineate the distribution and number of metastases, and hormonal studies to determine tumor functionality. Depending on these three factors, a combination of cytoreductive surgery, liver-directed therapies, and medical management-with cytostatic and cytotoxic chemotherapies, is utilized. The multidisciplinary management of patients with NeLM should carefully consider all these factors.

Keywords: Cytoreduction; DOTATATE; Hepatectomy; Liver; Metastatic; Neuroendocrine tumors.

MeSH terms

  • Hepatectomy
  • Humans
  • Intestinal Neoplasms* / pathology
  • Liver Neoplasms* / surgery
  • Neuroendocrine Tumors* / pathology
  • Surgeons*