神经内分泌肿瘤肝转移的治疗管理。
Management of neuroendocrine tumor liver metastases.
机构信息
Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
出版信息
Am J Surg. 2023 Nov;226(5):623-630. doi: 10.1016/j.amjsurg.2023.08.011. Epub 2023 Aug 16.
BACKGROUND
Neuroendocrine Tumors (NETs) are a group of tumors that arise from neuroendocrine cells, and are increasing in incidence worldwide. These tumors often metastasize to the liver, and management of these neuroendocrine tumor liver metastases (NELMs) requires a multi-disciplinary approach. We aim to provide a comprehensive update for treatment of NELMs.
METHODS
We completed a comprehensive systemic review of papers involving the diagnosis, treatment, and outcomes of NELMs. We identified 1612 records via Scopus database literature search. Two independent authors reviewed these records, with 318 meeting criteria for inclusion in the final systemic review.
RESULTS
Primary tumor resection with resection of liver metastases is the treatment of choice for patients with NELMs. Liver-directed therapies and liver transplantation can be considered for patients with unresectable liver metastases. Systemic medical therapy is used for managing tumor burden and symptoms caused by NELMs.
CONCLUSIONS
Advancement in liver-directed and targeted systemic therapies provide improved options for patients with unresectable tumors. Given the complexity of NELMs, management of NELMs necessitates multidisciplinary teams at comprehensive health centers.
背景
神经内分泌肿瘤（NETs）是一组起源于神经内分泌细胞的肿瘤，在全球范围内发病率不断上升。这些肿瘤常转移至肝脏，因此需要多学科方法来管理这些神经内分泌肿瘤肝脏转移（NELMs）。我们旨在为 NELMs 的治疗提供全面的更新。
方法
我们完成了对涉及 NELMs 的诊断、治疗和结局的论文的全面系统综述。我们通过 Scopus 数据库文献搜索确定了 1612 条记录。两名独立作者对这些记录进行了审查，其中 318 条符合纳入最终系统综述的标准。
结果
对于 NELMs 患者，首选原发肿瘤切除联合肝转移灶切除。对于无法切除肝转移灶的患者，可以考虑采用肝导向治疗和肝移植。对于因 NELMs 引起的肿瘤负荷和症状，可以使用全身药物治疗。
结论
肝导向和靶向全身治疗的进步为无法切除肿瘤的患者提供了更好的选择。鉴于 NELMs 的复杂性，需要综合医疗中心的多学科团队来管理 NELMs。
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