Department of Gastroenterology, King's College Hospital, SE5 9RS, London, U.K.
Neuroendocrine Tumour Unit, Institute of Liver Studies, King's College Hospital, SE5 9RS, London, U.K.
Curr Oncol Rep. 2024 Sep;26(9):1070-1084. doi: 10.1007/s11912-024-01559-w. Epub 2024 Jun 13.
This article aims to illustrate the current state of investigations and management of liver metastases in patients with Neuroendocrine Neoplasms. Neuroendocrine tumours (NETs) are rising in incidence globally and have become the second most prevalent gastrointestinal malignancy in UK and USA. Frequently, patients have metastatic disease at time of presentation. The liver is the most common site of metastases for gastro-enteropancreatic NETs. Characterisation of liver metastases with imaging is important to ensure disease is not under-staged.
Magnetic resonance imaging and positron emission tomography are now becoming standard of care for imaging liver metastases. There is an increasing armamentarium of therapies available for management of NETs and loco-regional therapy for liver metastases. The data supporting surgical and loco-regional therapy is reviewed with focus on role of liver transplantation. It is important to use appropriate imaging and classification of NET liver metastases. It is key that decisions regarding approach to treatment is undertaken in a multidisciplinary team and that individualised approaches are considered for management of patients with metastatic NETs.
本文旨在阐述神经内分泌肿瘤患者肝转移的当前研究和管理状况。神经内分泌肿瘤(NET)在全球的发病率呈上升趋势,已成为英国和美国第二常见的胃肠道恶性肿瘤。患者常于就诊时已发生转移。肝是胃肠胰神经内分泌肿瘤最常见的转移部位。通过影像学对肝转移进行特征描述对于确保疾病不被低估分期非常重要。
磁共振成像和正电子发射断层扫描现在已成为肝转移的常规影像学检查手段。NET 管理和局部区域治疗肝转移的治疗方法越来越多。本文重点讨论了肝移植在其中的作用,回顾了支持手术和局部区域治疗的数据。使用适当的影像学和 NET 肝转移分类非常重要。重要的是,在多学科团队中进行治疗方法决策,并考虑对转移性 NET 患者采用个体化治疗方法。