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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2012
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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. |
format | Online Article Text |
id | pubmed-3272804 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
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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