地标系列：神经内分泌肿瘤肝转移。
The Landmark Series: Neuroendocrine Tumor Liver Metastases.
机构信息
Division of Surgical Oncology, Department of Surgery, Cedars Sinai Medical Center, 8700 Beverly Blvd, AC 1049, Los Angeles, CA, 90048, USA.
Surgical Oncology and Endocrine Surgery, University of Iowa Carver College of Medicine, University of Iowa Hospitals and Clinics, 4644 JCP, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
出版信息
Ann Surg Oncol. 2020 Sep;27(9):3270-3280. doi: 10.1245/s10434-020-08787-x. Epub 2020 Jul 6.
BACKGROUND
Neuroendocrine tumors are becoming increasingly prevalent, with many patients presenting with or developing metastatic disease to the liver.
METHODS
In this landmark series paper, we highlight the critical studies that have defined the surgical management of neuroendocrine tumor liver metastases, as well as several randomized control trials which have investigated strategies for systemic control of metastatic disease.
RESULTS
Liver-directed surgical approaches and locally ablative procedures are recommended for patients with limited, resectable, and in some cases, nonresectable tumor burden. Angiographic liver-directed techniques, such as transarterial embolization, chemoembolization, and radioembolization, offer another approach for management in patients with liver-predominant disease. Peptide receptor radionuclide therapy is a promising therapy for patients with hepatic and/or extrahepatic metastases. Various systemic medical therapies are also available as adjunct or definitive therapy for patients with metastatic disease.
CONCLUSIONS
This article reviews current data regarding management of neuroendocrine liver metastases and highlights areas for future study.
背景
神经内分泌肿瘤的发病率越来越高，许多患者出现肝转移或发展为肝转移。
方法
在本系列标志性论文中，我们重点介绍了明确神经内分泌肿瘤肝转移手术治疗的关键研究，以及几项探讨转移性疾病全身控制策略的随机对照试验。
结果
对于局限性、可切除和某些情况下不可切除肿瘤负荷的患者，推荐采用肝定向手术和局部消融治疗。血管内肝定向技术，如经动脉栓塞、化疗栓塞和放射性栓塞，为肝优势疾病患者的治疗提供了另一种方法。肽受体放射性核素治疗是治疗肝内和/或肝外转移患者的一种有前途的治疗方法。对于转移性疾病患者，还可使用各种全身药物治疗作为辅助或根治性治疗。
结论
本文综述了目前关于神经内分泌肝脏转移的管理数据，并强调了未来研究的领域。
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