Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Clin J Gastroenterol. 2022 Dec;15(6):1136-1144. doi: 10.1007/s12328-022-01689-3. Epub 2022 Aug 29.
The presence of neuroendocrine liver metastases is one of the poorest prognostic factors in patients with pancreatic neuroendocrine neoplasms, and surgical resection of neuroendocrine liver metastases is the only curable treatment. A 38-year-old man had a pancreatic neuroendocrine neoplasm with synchronous multiple liver metastases, and two surgeries and continuous everolimus and octreotide achieved R0 resection. However, multiple neuroendocrine liver metastases developed twice after more than 5 years of recurrence-free survival. Aggressive repeat hepatectomy was performed and he has survived for more than 10 years after the initial surgery. This report highlights that patients with pancreatic neuroendocrine neoplasms have a potential risk of recurrence even after 5 years of recurrence-free survival. In addition, combined aggressive hepatectomy and continuous medication can contribute dramatically to long-term survival even for late-stage recurrence of liver metastases.
神经内分泌肝转移的存在是胰腺神经内分泌肿瘤患者预后最差的因素之一，而神经内分泌肝转移的手术切除是唯一可治愈的治疗方法。一名 38 岁男性患有胰腺神经内分泌肿瘤，同时伴有多个肝转移灶，经过两次手术和持续使用依维莫司和奥曲肽治疗，实现了 R0 切除。然而，在无复发生存超过 5 年后，又两次出现多发神经内分泌肝转移。进行了积极的重复肝切除术，自初始手术以来，他已经存活了 10 年以上。本报告强调，即使在无复发生存超过 5 年后，胰腺神经内分泌肿瘤患者仍有复发的潜在风险。此外，即使是肝转移晚期复发，积极的联合肝切除术和持续药物治疗也能显著延长患者的生存时间。
