Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy; Research Institute Against Digestive Cancer (IRCAD), Strasbourg, France.
Department of General and Emergency Surgery, Ospedale San Filippo Neri, Rome, Italy.
HPB (Oxford). 2022 Nov;24(11):1832-1843. doi: 10.1016/j.hpb.2022.06.009. Epub 2022 Jun 21.
Gastroenteropancreatic neuroendocrine tumors are often diagnosed when metastatic. The liver is the main site of metastases. Unfortunately, optimal management of neuroendocrine liver metastases remains a topic of debate. The aim of this study was to make a systematic review of the current literature about the results of the different treatments of neuroendocrine liver metastases.
A systematic review was conducted for English language publications from 1995 to 2021. Outcomes were analyzed according to survival, disease-free survival, and in the case of systemic therapies, progression-free survival.
5509 patients were analyzed in the review. 67% of patients underwent surgery achieving 5 years overall survival despite only 30% percent without a recurrence. 60% of patients that had received a transplant reached 5 years survival with a low disease-free survival rate (20%). Five-year survival rate was 36.2% for patients undergoing loco-regional therapies.
Surgical resection is the best treatment when metastases are resectable, with the highest rate of survival, although liver transplantation shows good results for patients not eligible for surgery. Loco-regional therapies may be useful when surgical resection is contraindicated, or selectively used as a bridge to surgery or transplantation. Systemic therapies are indicated in patients for whom curative treatment cannot be obtained.
胃肠胰神经内分泌肿瘤通常在转移时被诊断出来。肝脏是转移的主要部位。不幸的是，神经内分泌肝转移的最佳治疗方法仍然存在争议。本研究的目的是对目前关于神经内分泌肝转移不同治疗结果的文献进行系统回顾。
对 1995 年至 2021 年发表的英文文献进行系统回顾。根据生存、无病生存以及在全身治疗的情况下，无进展生存情况分析结果。
该综述分析了 5509 名患者。尽管 30%的患者没有复发，但 67%的患者接受了手术治疗，5 年总生存率达到 5 年。接受移植的 60%患者达到 5 年生存率，无疾病生存率较低（20%）。局部区域治疗的患者 5 年生存率为 36.2%。
当转移灶可切除时，手术切除是最佳治疗方法，生存率最高，尽管肝移植对不符合手术条件的患者显示出良好的结果。当手术切除禁忌时，局部区域治疗可能有用，或者选择性地用作手术或移植的桥梁。对于无法获得治愈性治疗的患者，应采用全身治疗。
