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Surgical Treatment of Neuroendocrine Liver Metastases

Management of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database wa...

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Autores principales: Lee, Ser Yee, Cheow, Peng Chung, Teo, Jin Yao, Ooi, London L. P. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272804/
https://www.ncbi.nlm.nih.gov/pubmed/22319650
http://dx.doi.org/10.1155/2012/146590
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author Lee, Ser Yee
Cheow, Peng Chung
Teo, Jin Yao
Ooi, London L. P. J.
author_facet Lee, Ser Yee
Cheow, Peng Chung
Teo, Jin Yao
Ooi, London L. P. J.
author_sort Lee, Ser Yee
collection PubMed
description Management of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database was performed from 1995–2010, to collate the current evidence and formulate a sound management algorithm. There are 22 case series with a total of 793 patients who had undergone surgery for NELM. The overall survival ranges from 46–86% at 5 years, 35–79% at 10 years, and the median survival ranges from 52–123 months. After successful cytoreductive surgery, the mean duration of symptom reduction is between 16–26 months, and the 5-year recurrence/progression rate ranges from 59–76%. Five studies evaluated the efficacy of a combination cytoreductive strategy reporting survival rate of ranging from 83% at 3 years to 50% at 10 years. To date, there is no level 1 evidence comparing surgery versus other liver-directed treatment options for NELM. An aggressive surgical approach, including combination with additional liver-directed procedures is recommended as it leads to long-term survival, significant long-term palliation, and a good quality of life. A multidisciplinary approach should be established as the platform for decision making.
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spelling pubmed-32728042012-02-08 Surgical Treatment of Neuroendocrine Liver Metastases Lee, Ser Yee Cheow, Peng Chung Teo, Jin Yao Ooi, London L. P. J. Int J Hepatol Review Article Management of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database was performed from 1995–2010, to collate the current evidence and formulate a sound management algorithm. There are 22 case series with a total of 793 patients who had undergone surgery for NELM. The overall survival ranges from 46–86% at 5 years, 35–79% at 10 years, and the median survival ranges from 52–123 months. After successful cytoreductive surgery, the mean duration of symptom reduction is between 16–26 months, and the 5-year recurrence/progression rate ranges from 59–76%. Five studies evaluated the efficacy of a combination cytoreductive strategy reporting survival rate of ranging from 83% at 3 years to 50% at 10 years. To date, there is no level 1 evidence comparing surgery versus other liver-directed treatment options for NELM. An aggressive surgical approach, including combination with additional liver-directed procedures is recommended as it leads to long-term survival, significant long-term palliation, and a good quality of life. A multidisciplinary approach should be established as the platform for decision making. Hindawi Publishing Corporation 2012 2012-01-26 /pmc/articles/PMC3272804/ /pubmed/22319650 http://dx.doi.org/10.1155/2012/146590 Text en Copyright © 2012 Ser Yee Lee et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Lee, Ser Yee
Cheow, Peng Chung
Teo, Jin Yao
Ooi, London L. P. J.
Surgical Treatment of Neuroendocrine Liver Metastases
title Surgical Treatment of Neuroendocrine Liver Metastases
title_full Surgical Treatment of Neuroendocrine Liver Metastases
title_fullStr Surgical Treatment of Neuroendocrine Liver Metastases
title_full_unstemmed Surgical Treatment of Neuroendocrine Liver Metastases
title_short Surgical Treatment of Neuroendocrine Liver Metastases
title_sort surgical treatment of neuroendocrine liver metastases
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272804/
https://www.ncbi.nlm.nih.gov/pubmed/22319650
http://dx.doi.org/10.1155/2012/146590
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