Yuan C H, Tao L Y, Xiu D R
Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Wai Ke Za Zhi. 2017 Sep 1;55(9):650-654. doi: 10.3760/cma.j.issn.0529-5815.2017.09.003.
Liver metastasis is the one of the main prognostic factors of pancreatic neuroendocrine neoplasm (PNEN). With the development of multidisciplinary collaboration among surgical oncology, medical oncology, and intervention treatment, the treatment of PNEN with liver metastasis gradually tends to become diversification. Surgery is still the only way for curing the patients with pancreatic neuroendocrine tumor with liver metastasis when the histological types are G1 and G2. Medical oncology and intervention treatment could be selected for those having PNEN with diffuse liver metastasis or those cannot tolerate surgery. Liver transplantation only suits for a small number of selected patients. The present article explored the relationship between histological classifications and the treatment options of PNEN with liver metastasis, and discussed the specific treatments from perspectives of surgical treatment, medical treatment and intervention treatment.
肝转移是胰腺神经内分泌肿瘤(PNEN)的主要预后因素之一。随着外科肿瘤学、内科肿瘤学及介入治疗多学科协作的发展,PNEN伴肝转移的治疗逐渐趋于多样化。当组织学类型为G1和G2时,手术仍是治愈胰腺神经内分泌肿瘤伴肝转移患者的唯一方法。对于有PNEN伴弥漫性肝转移或无法耐受手术的患者,可选择内科肿瘤学和介入治疗。肝移植仅适用于少数经过挑选的患者。本文探讨了PNEN伴肝转移的组织学分类与治疗选择之间的关系,并从手术治疗、药物治疗和介入治疗的角度讨论了具体治疗方法。