Department of Medical and Surgical Science and Translational Medicine, St. Andrea Hospital Rome, Sapienza University of Rome, Via di Grottarossa 1035, 00189, Rome, Italy.
Digestive Surgery, Hepatobiliopancreatic Surgery and Liver Transplantation, UPEC University, Henri Mondor Hospital, Creteil, France.
World J Surg Oncol. 2018 Jul 14;16(1):142. doi: 10.1186/s12957-018-1446-y.
Pancreatic neuroendocrine tumors (PNETs) are rare pancreatic neoplasms. About 40-80% of patients with PNET are metastatic at presentation, usually involving the liver (40-93%). Liver metastasis represents the most significant prognostic factor. The aim of this study is to present an up-to-date review of treatment options for patients with liver metastases from PNETs.
A systematic literature search was performed using the PubMed database to identify all pertinent studies published up to May 2018.
The literature search evaluated all the therapeutic options for patients with liver metastases of PNETs, including surgical treatment, loco-regional therapies, and pharmacological treatment. All the different treatment options showed particular indications in different presentations of liver metastases of PNET. Surgery remains the only potentially curative therapeutic option in patients with PNETs and resectable liver metastases, even if relapse rates are high. Efficacy of medical treatment has increased with advances in targeted therapies, such as everolimus and sunitinib, and the introduction of radiolabeled somatostatin analogs. Several techniques for loco-regional control of metastases are available, including chemo- or radioembolization.
Treatment of patients with PNET metastases should be multidisciplinary and must be personalized according to the features of individual patients and tumors.
胰腺神经内分泌肿瘤（PNETs）是一种罕见的胰腺肿瘤。约 40-80%的 PNET 患者在就诊时发生转移，通常累及肝脏（40-93%）。肝脏转移是最重要的预后因素。本研究旨在对 PNET 肝转移患者的治疗选择进行最新的综述。
使用 PubMed 数据库进行系统文献检索，以确定截至 2018 年 5 月发表的所有相关研究。
文献检索评估了 PNET 肝转移患者的所有治疗选择，包括手术治疗、局部区域治疗和药物治疗。所有不同的治疗选择在 PNET 肝转移的不同表现中都有特定的适应证。手术仍然是可切除肝转移的 PNET 患者唯一有治愈可能的治疗选择，尽管复发率较高。随着靶向治疗（如依维莫司和舒尼替尼）的进步，以及放射性标记生长抑素类似物的引入，药物治疗的疗效有所提高。有几种局部区域控制转移的技术，包括化疗栓塞或放射栓塞。
PNET 转移患者的治疗应采用多学科方法，并应根据个体患者和肿瘤的特点进行个体化治疗。
