Lai Quirino, Coppola Alessandro, Mrzljak Anna, Cigrovski Berkovic Maja
General Surgery and Organ Transplantation Unit, Department of General and Specialty Surgery, Sapienza University of Rome, 00161 Rome, Italy.
Department of General Surgery, Sapienza University of Rome, 00161 Rome, Italy.
Biomedicines. 2024 Oct 22;12(11):2419. doi: 10.3390/biomedicines12112419.
BACKGROUND/OBJECTIVES: Neuroendocrine neoplasms (NEN) are heterogeneous entities. Despite considerable advancement in the field, almost 50% of patients have metastatic disease, when liver transplantation (LT) is one of the possible treatments offering a cure in well-selected patients.
The present study aims to systematically review all the literature from 2000 onwards on using LT for patients with NEN-LM, with particular attention to the risk factors of death and recurrence.
LT offers 5-year OS ranging from 52 to 74% and 5-year TFS rates ranging from 39 to 62%, with even better results published from 2009 onwards. The main risk factors for patient deaths are related to unfavorable primary tumor pathology, higher liver involvement, and simultaneous LT and primary resection. Similarly, recurrence is higher related to poor tumor grade and differentiation, and in the case of an older recipient age.
Applying uniform criteria and a more in-depth understanding of the relevant prognostic factors contribute to a better selection of candidates for curative LT due to NEN metastases. LT for unresectable or liver-restricted NENs has a relevant place in the treatment algorithm and has achieved excellent results in recent decades, but more international efforts are needed to further improve outcomes.
背景/目的：神经内分泌肿瘤（NEN）是异质性疾病。尽管该领域取得了显著进展，但几乎50%的患者患有转移性疾病，而肝移植（LT）是为精心挑选的患者提供治愈机会的可能治疗方法之一。
本研究旨在系统回顾2000年以来所有关于对NEN-LM患者进行肝移植的文献，特别关注死亡和复发的危险因素。
肝移植的5年总生存率为52%至74%，5年无病生存率为39%至62%，2009年以后发表的结果甚至更好。患者死亡的主要危险因素与原发肿瘤病理不佳、肝脏受累程度较高以及同时进行肝移植和原发灶切除有关。同样，复发率较高与肿瘤分级和分化较差以及受者年龄较大有关。
应用统一标准并更深入地了解相关预后因素有助于更好地选择因NEN转移而适合进行根治性肝移植的患者。对于不可切除或局限于肝脏的NENs，肝移植在治疗方案中占有重要地位，并且在最近几十年取得了优异的成果，但需要更多的国际努力来进一步改善治疗效果。
