Multimodal management of neuroendocrine liver metastases
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Multimodal management of neuroendocrine liver metastases. / Frilling, Andrea; Sotiropoulos, Georgios C; Li, Jun; Kornasiewicz, Oskar; Plöckinger, Ursula.
In: HPB, Vol. 12, No. 6, 08.2010, p. 361-79.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Multimodal management of neuroendocrine liver metastases
AU - Frilling, Andrea
AU - Sotiropoulos, Georgios C
AU - Li, Jun
AU - Kornasiewicz, Oskar
AU - Plöckinger, Ursula
PY - 2010/8
Y1 - 2010/8
N2 - BACKGROUND: The incidence of neuroendocrine tumours (NET) has increased over the past three decades. Hepatic metastases which occur in up to 75% of NET patients significantly worsen their prognosis. New imaging techniques with increasing sensitivity enabling tumour detection at an early stage have been developed. The treatment encompasses a panel of surgical and non-surgical modalities.METHODS: This article reviews the published literature related to management of hepatic neuroendocrine metastases.RESULTS: Abdominal computer tomography, magnetic resonance tomography and somatostatin receptor scintigraphy are widely accepted imaging modalities. Hepatic resection is the only potentially curative treatment. Liver transplantation is justified in highly selected patients. Liver-directed interventional techniques and locally ablative measures offer effective palliation. Promising novel therapeutic options offering targeted approaches are under evaluation.CONCLUSIONS: The treatment of neuroendocrine liver metastases still needs to be standardized. Management in centres of expertise should be strongly encouraged in order to enable a multidisciplinary approach and personalized treatment. Development of molecular prognostic factors to select treatment according to patient risk should be attempted.
AB - BACKGROUND: The incidence of neuroendocrine tumours (NET) has increased over the past three decades. Hepatic metastases which occur in up to 75% of NET patients significantly worsen their prognosis. New imaging techniques with increasing sensitivity enabling tumour detection at an early stage have been developed. The treatment encompasses a panel of surgical and non-surgical modalities.METHODS: This article reviews the published literature related to management of hepatic neuroendocrine metastases.RESULTS: Abdominal computer tomography, magnetic resonance tomography and somatostatin receptor scintigraphy are widely accepted imaging modalities. Hepatic resection is the only potentially curative treatment. Liver transplantation is justified in highly selected patients. Liver-directed interventional techniques and locally ablative measures offer effective palliation. Promising novel therapeutic options offering targeted approaches are under evaluation.CONCLUSIONS: The treatment of neuroendocrine liver metastases still needs to be standardized. Management in centres of expertise should be strongly encouraged in order to enable a multidisciplinary approach and personalized treatment. Development of molecular prognostic factors to select treatment according to patient risk should be attempted.
KW - Antineoplastic Combined Chemotherapy Protocols
KW - Biomarkers, Tumor
KW - Biopsy
KW - Catheter Ablation
KW - Chemoembolization, Therapeutic
KW - Diagnostic Imaging
KW - Hepatectomy
KW - Humans
KW - Liver Neoplasms
KW - Liver Transplantation
KW - Neuroendocrine Tumors
KW - Palliative Care
KW - Patient Selection
KW - Risk Assessment
KW - Treatment Outcome
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
KW - Review
U2 - 10.1111/j.1477-2574.2010.00175.x
DO - 10.1111/j.1477-2574.2010.00175.x
M3 - SCORING: Review article
C2 - 20662787
VL - 12
SP - 361
EP - 379
JO - HPB
JF - HPB
SN - 1365-182X
IS - 6
ER -
