Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University. No.1, East Jianshe Road, Zhengzhou.
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, China.
Medicine (Baltimore). 2020 Dec 18;99(51):e23655. doi: 10.1097/MD.0000000000023655.
Hepatic neuroendocrine tumors (HNETs) are uncommon neoplasms that can be subdivided into 2 types: primary and metastatic HNETs. Due to its rarity, heterogeneity and complexity, the diagnosis, treatment modalities and prognosis are still controversial.This retrospective study reviewed the effects of tumor origins and therapeutic options on the prognosis of gastroenteropancreatic neuroendocrine tumors with liver metastasis (GEP-NETLM) and primary hepatic neuroendocrine tumors (PHNETs), providing additional evidence for clinicians evaluating patients.HNETs consisted of PHNETs and GEP-NETLM. GEP-NETLM (76.2%, 112/147) was more common, which was mainly manifested as multiple lesions in both lobes of the liver. PHNETs were relatively rare (23.8%, 35/147) and were mainly single lesion located in the right lobe of the liver. In patients with GEP-NETLM, primary tumor resection could prolong survival (P = .044). As the most widely used treatment method, systematic therapy alone could not achieve a satisfactory survival. However, the combination with hepatectomy or liver-directed therapy improved the prognosis (P = .023). As the main treatment, patients with PHNETs treated with local therapy could achieve a better prognosis (P = .049). Compared with PHNETs patients, GEP-NETLM patients with higher ki-67 index showed higher mortality and poorer prognosis (P = .006).Therefore, patients with PHNETs can be distinguished from GEP-NETLM by comprehensive imaging examinations and long-term follow-ups. The choice of appropriate treatment strategies can improve the prognosis of HNETs patients.
肝神经内分泌肿瘤(HNETs)是一种罕见的肿瘤,可以分为 2 种类型:原发性和转移性 HNETs。由于其罕见性、异质性和复杂性,诊断、治疗方式和预后仍存在争议。本回顾性研究探讨了肿瘤起源和治疗选择对胃肠胰神经内分泌肿瘤伴肝转移(GEP-NETLM)和原发性肝神经内分泌肿瘤(PHNETs)患者预后的影响,为评估患者的临床医生提供了额外的证据。HNETs 包括 PHNETs 和 GEP-NETLM。GEP-NETLM(76.2%,112/147)更为常见,主要表现为肝两叶多发病灶。PHNETs 相对少见(23.8%,35/147),主要为右叶单发病变。在 GEP-NETLM 患者中,原发肿瘤切除可延长生存(P=0.044)。作为最广泛应用的治疗方法,系统治疗单独应用并不能达到满意的生存。然而,联合肝切除术或肝定向治疗可改善预后(P=0.023)。作为主要治疗方法,局部治疗的 PHNETs 患者可获得更好的预后(P=0.049)。与 PHNETs 患者相比,ki-67 指数较高的 GEP-NETLM 患者死亡率更高,预后更差(P=0.006)。因此,PHNETs 患者可以通过综合影像学检查和长期随访与 GEP-NETLM 患者相区分。选择合适的治疗策略可以改善 HNETs 患者的预后。