The Role of Liver Transplantation in the Treatment of Liver Metastases from Neuroendocrine Tumors

Transplant oncology is a new field of medicine referred to the use of solid organ transplantation, particularly the liver, to improve prognosis and quality of life in cancer patients. In unresectable, liver-only metastases from neuroendocrine tumors (NETs) of the digestive tract, liver transplantati...

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Autores principales: Citterio, Davide, Coppa, Jorgelina, Sposito, Carlo, Busset, Michele Droz Dit, Virdis, Matteo, Pezzoli, Isabella, Mazzaferro, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643461/
https://www.ncbi.nlm.nih.gov/pubmed/37882889
http://dx.doi.org/10.1007/s11864-023-01124-w
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author Citterio, Davide
Coppa, Jorgelina
Sposito, Carlo
Busset, Michele Droz Dit
Virdis, Matteo
Pezzoli, Isabella
Mazzaferro, Vincenzo
author_facet Citterio, Davide
Coppa, Jorgelina
Sposito, Carlo
Busset, Michele Droz Dit
Virdis, Matteo
Pezzoli, Isabella
Mazzaferro, Vincenzo
author_sort Citterio, Davide
collection PubMed
description Transplant oncology is a new field of medicine referred to the use of solid organ transplantation, particularly the liver, to improve prognosis and quality of life in cancer patients. In unresectable, liver-only metastases from neuroendocrine tumors (NETs) of the digestive tract, liver transplantation represents a competitive chance of cure. Due to the limited resource of donated organs, accurate patients’ selection is crucial in order to maximize transplant benefit. Several tumor- and patient-related factors should be considered. Among them, primary tumors with a low grade of differentiation (G1-G2 or Ki67 < 10%), located in a region drained by the portal system and removed before transplantation with at least 3–6 months period of disease stability observed before transplant listing, can be considered for transplantation. In case of NET located in the pancreas, extended lymphadenectomy should complement curative pancreatic resection. A number of other features are described in this review of liver transplantation for NET metastases. Comprehensive approach including various forms of non-surgical treatment and detailed planning and timing of total hepatectomy are discussed. Open issues remain on possible expansion of current criteria while maintaining the same long-term benefit demonstrated with the Milan NET criteria with respect to other non-transplant options, with particular reference to liver resection, peptide receptor radionuclide therapy, and locoregional and systemic treatments.
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spelling pubmed-106434612023-11-14 The Role of Liver Transplantation in the Treatment of Liver Metastases from Neuroendocrine Tumors Citterio, Davide Coppa, Jorgelina Sposito, Carlo Busset, Michele Droz Dit Virdis, Matteo Pezzoli, Isabella Mazzaferro, Vincenzo Curr Treat Options Oncol Article Transplant oncology is a new field of medicine referred to the use of solid organ transplantation, particularly the liver, to improve prognosis and quality of life in cancer patients. In unresectable, liver-only metastases from neuroendocrine tumors (NETs) of the digestive tract, liver transplantation represents a competitive chance of cure. Due to the limited resource of donated organs, accurate patients’ selection is crucial in order to maximize transplant benefit. Several tumor- and patient-related factors should be considered. Among them, primary tumors with a low grade of differentiation (G1-G2 or Ki67 < 10%), located in a region drained by the portal system and removed before transplantation with at least 3–6 months period of disease stability observed before transplant listing, can be considered for transplantation. In case of NET located in the pancreas, extended lymphadenectomy should complement curative pancreatic resection. A number of other features are described in this review of liver transplantation for NET metastases. Comprehensive approach including various forms of non-surgical treatment and detailed planning and timing of total hepatectomy are discussed. Open issues remain on possible expansion of current criteria while maintaining the same long-term benefit demonstrated with the Milan NET criteria with respect to other non-transplant options, with particular reference to liver resection, peptide receptor radionuclide therapy, and locoregional and systemic treatments. Springer US 2023-10-26 2023 /pmc/articles/PMC10643461/ /pubmed/37882889 http://dx.doi.org/10.1007/s11864-023-01124-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Citterio, Davide
Coppa, Jorgelina
Sposito, Carlo
Busset, Michele Droz Dit
Virdis, Matteo
Pezzoli, Isabella
Mazzaferro, Vincenzo
The Role of Liver Transplantation in the Treatment of Liver Metastases from Neuroendocrine Tumors
title The Role of Liver Transplantation in the Treatment of Liver Metastases from Neuroendocrine Tumors
title_full The Role of Liver Transplantation in the Treatment of Liver Metastases from Neuroendocrine Tumors
title_fullStr The Role of Liver Transplantation in the Treatment of Liver Metastases from Neuroendocrine Tumors
title_full_unstemmed The Role of Liver Transplantation in the Treatment of Liver Metastases from Neuroendocrine Tumors
title_short The Role of Liver Transplantation in the Treatment of Liver Metastases from Neuroendocrine Tumors
title_sort role of liver transplantation in the treatment of liver metastases from neuroendocrine tumors
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643461/
https://www.ncbi.nlm.nih.gov/pubmed/37882889
http://dx.doi.org/10.1007/s11864-023-01124-w
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