Orozco Gabriel, Ramaiah Dharani, Cracco Alejandro, Desai Siddharth, Gedaly Roberto
Department of Surgery, University of Kentucky, Med Center Health (Bowling Green), Bowling Green, KY, United States.
Department of Surgery - Transplant Division, College of Medicine, University of Kentucky, Lexington, KY, United States.
Front Surg. 2025 Jul 1;12:1603704. doi: 10.3389/fsurg.2025.1603704. eCollection 2025.
Neuroendocrine liver metastases (NELM) are commonly observed in patients with advanced neuroendocrine tumors (NETs) and are associated with poor prognosis, primarily due to liver failure and hormone-related complications. While hepatic resection remains the standard surgical approach, orthotopic liver transplantation (OLT) has emerged as a potentially curative treatment in selected patients with unresectable disease. This review summarizes current evidence on the role of OLT in managing NELM, with a focus on patient selection criteria and existing clinical guidelines. Appropriate selection is essential, as improved long-term survival has been consistently demonstrated in patients who meet established eligibility parameters. In conclusion, OLT offers meaningful survival benefits for carefully selected patients with NELM. A multidisciplinary approach and ongoing research into prognostic markers and adjunctive therapies are critical to optimizing outcomes in this challenging clinical setting.
神经内分泌性肝转移瘤(NELM)在晚期神经内分泌肿瘤(NET)患者中较为常见,且与预后不良相关,主要原因是肝衰竭和激素相关并发症。虽然肝切除术仍是标准的手术方法,但原位肝移植(OLT)已成为部分无法切除疾病患者的一种潜在治愈性治疗手段。本综述总结了当前关于OLT在治疗NELM中作用的证据,重点关注患者选择标准和现有临床指南。恰当的选择至关重要,因为符合既定入选标准的患者长期生存率持续提高。总之,OLT为精心挑选的NELM患者提供了显著的生存获益。多学科方法以及对预后标志物和辅助治疗的持续研究对于在这一具有挑战性的临床环境中优化治疗结果至关重要。