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肝移植治疗转移性神经内分泌肿瘤:单中心报告。

LIVER TRANSPLANT FOR METASTATIC NEUROENDOCRINE TUMORS: A SINGLE-CENTER REPORT.

机构信息

Hospital Universitário Walter Cantídio, Digestive Surgical Unit - Fortaleza (CE), Brazil.

Hospital Universitário Walter Cantídio, Liver Transplant Unit - Fortaleza (CE), Brazil.

出版信息

Arq Bras Cir Dig. 2023 Jul 17;36:e1750. doi: 10.1590/0102-672020230032e1750. eCollection 2023.

Abstract

BACKGROUND

Neuroendocrine tumors are rare neoplasms of uncertain biological behavior. The liver is one of the most common sites of metastases, occurring in 50% of patients with metastatic disease.

AIMS

To analyze a clinical series in liver transplant of patients with neuroendocrine tumors metastases.

METHODS

A retrospective descriptive study, based on the review of medical records of patients undergoing liver transplants due to neuroendocrine tumor metastases in a single center in northeast Brazil, over a period of 20 years (January 2001 to December 2021).

RESULTS

During the analyzed period, 2,000 liver transplants were performed, of which 11 were indicated for liver metastases caused by neuroendocrine tumors. The mean age at diagnosis was 45.09±14.36 years (26-66 years) and 72.7% of cases were females. The most common primary tumor site was in the gastrointestinal tract in 64% of cases. Even after detailed investigation, three patients had no primary tumor site identified (27%). Overall survival after transplantation at one month was 90%, at one year was 70%, and five year, 45.4%. Disease-free survival rate was 72.7% at one year and 36.3% at five years.

CONCLUSIONS

Liver transplantation is a treatment modality with good overall survival and disease-free survival results in selected patients with unresectable liver metastases from neuroendocrine tumors. However, a rigorous selection of patients is necessary to obtain better results and the ideal time for transplant indication is still a controversial topic in the literature.

摘要

背景

神经内分泌肿瘤是一种生物学行为不确定的罕见肿瘤。肝脏是最常见的转移部位之一,约 50%的转移性疾病患者发生肝转移。

目的

分析肝脏移植治疗神经内分泌肿瘤肝转移患者的临床系列。

方法

这是一项回顾性描述性研究,基于对巴西东北部一家中心因神经内分泌肿瘤肝转移而行肝移植的患者的病历回顾,研究时间为 20 年(2001 年 1 月至 2021 年 12 月)。

结果

在分析期间,共进行了 2000 例肝移植,其中 11 例是由于神经内分泌肿瘤引起的肝转移而进行的。诊断时的平均年龄为 45.09±14.36 岁(26-66 岁),72.7%的病例为女性。最常见的原发肿瘤部位是胃肠道,占 64%。即使进行了详细的调查,仍有 3 例患者未确定原发肿瘤部位(27%)。移植后一个月的总体生存率为 90%,一年生存率为 70%,五年生存率为 45.4%。一年无病生存率为 72.7%,五年无病生存率为 36.3%。

结论

对于无法切除的神经内分泌肿瘤肝转移患者,肝移植是一种具有良好总体生存率和无病生存率的治疗方法。然而,需要对患者进行严格选择,以获得更好的结果,并且移植适应证的理想时机在文献中仍然是一个有争议的话题。

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本文引用的文献

1
Neuroendocrine liver metastases: The role of liver transplantation.神经内分泌肝转移瘤:肝移植的作用
Transplant Rev (Orlando). 2021 Apr;35(2):100595. doi: 10.1016/j.trre.2021.100595. Epub 2021 Jan 15.
5
Liver transplantation in patients with liver metastases from neuroendocrine tumors.神经内分泌肿瘤肝转移患者的肝移植
Minerva Chir. 2019 Oct;74(5):399-406. doi: 10.23736/S0026-4733.19.08119-7. Epub 2019 Jul 5.

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