Dermine Solène, Palmieri Lola-Jade, Lavolé Julie, Barré Amélie, Dohan Antony, Abou Ali Einas, Cottereau Anne-Ségolène, Gaujoux Sébastien, Brezault Catherine, Chaussade Stanislas, Coriat Romain
Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France.
Department of Gastroenterology, Cochin Teaching Hospital, Université de Paris, 75014 Paris, France.
J Clin Med. 2019 Nov 7;8(11):1907. doi: 10.3390/jcm8111907.
The incidence of liver metastasis in digestive neuroendocrine tumors is high. Their presence appears as an important prognostic factor in terms of quality of life and survival. These tumors may be symptomatic because of the tumor burden itself and/or the hormonal hyper-secretion induced by the tumor. Surgery is the treatment of choice for resectable tumors and metastasis. Nevertheless, surgery is only possible in a small number of cases. The management of non-resectable liver metastasis is a challenge. The literature is rich but consists predominantly in small retrospective series with a low level of proof. Thus, the choice of one technique over another could be difficult. Local ablative techniques (radiofrequency) or trans-catheter intra-arterial liver-directed treatments (hepatic artery embolization, chemo-embolization, and radio-embolization) are frequently considered for liver metastasis. In the present review, we focus on these different therapeutic approaches in advanced neuroendocrine tumors, results (clinical and radiological), and overall efficacy, and summarize recommendations to help physicians in their clinical practice.
消化性神经内分泌肿瘤肝转移的发生率很高。其存在似乎是生活质量和生存方面的一个重要预后因素。这些肿瘤可能因肿瘤负荷本身和/或肿瘤诱导的激素过度分泌而出现症状。手术是可切除肿瘤和转移灶的首选治疗方法。然而，手术仅在少数情况下可行。不可切除肝转移灶的管理是一项挑战。相关文献丰富，但主要是证据水平较低的小型回顾性系列研究。因此，在不同技术之间做出选择可能很困难。局部消融技术（射频）或经导管肝动脉靶向治疗（肝动脉栓塞、化疗栓塞和放射性栓塞）常用于肝转移的治疗。在本综述中，我们聚焦于晚期神经内分泌肿瘤的这些不同治疗方法、结果（临床和影像学）及总体疗效，并总结相关建议以帮助医生进行临床实践。
