Journal article
Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas: A surgeon's plea to centering attention on the liver
Seminars in oncology, Vol.45(4), pp.232-235
08/2018
DOI: 10.1053/j.seminoncol.2018.07.002
PMID: 30318110
Abstract
Over 50% of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have stage IV disease at presentation and the most likely organ to be affected by metastases is the liver. Hepatic involvement and hepatic tumor burden is a key prognostic factor affecting survival of these patients and 80% eventually die of liver failure due to tumor dissemination within the liver. This commentary explores the efficacy and limitations of systemic treatments in patients with GEP-NETs and liver metastases. Landmark randomized trials using systemic therapies including sandostatin (PROMID), lanreotide (CLARINET), everolimus (RADIANT 3 and 4), sunitinib and Peptide Receptor Radionuclide Therapy (NETTER-1) have not shown efficacy in reducing liver tumor burden in patients with stage IV GEP-NETs with liver metastases as outlined in this review. Although often overlooked, surgical debulking has been associated with a significant survival advantage in large retrospective studies and in our opinion should remain an important therapeutic option for patients with stage IV GEP-NETs and liver metastases.
Details
- Title: Subtitle
- Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas: A surgeon's plea to centering attention on the liver
- Creators
- Xavier M Keutgen - Rush University Medical Center, Department of Surgery, Division of Surgical Oncology, Chicago, IL, USAErik Schadde - Rush University Medical Center, Department of Surgery, Division of Surgical Oncology, Chicago, IL, USARodney F Pommier - Oregon Health & Science University, Department of Surgery, Division of Surgical Oncology, Portland, OR, USAThorvardur R Halfdanarson - Mayo Clinic, Department of Oncology, Division of Medical Oncology, Rochester, MN, USAJames R Howe - University of Iowa, Department of Surgery, Division of Surgical Oncology, Iowa City, IA, USAElectron Kebebew - Stanford University, Department of Surgery, Division of Surgical Oncology, Stanford, CA, USA
- Resource Type
- Journal article
- Publication Details
- Seminars in oncology, Vol.45(4), pp.232-235
- Publisher
- Elsevier Inc
- DOI
- 10.1053/j.seminoncol.2018.07.002
- PMID
- 30318110
- ISSN
- 0093-7754
- eISSN
- 1532-8708
- Language
- English
- Date published
- 08/2018
- Academic Unit
- Surgery
- Record Identifier
- 9984051758102771
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