Current Management of Neuroendocrine Tumour Liver Metastases

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• Morin C, Drolet S, Daigle C, Deshaies I, Ouellet JF, Ball CG, Dixon E, Marceau J, Ouellet JB. Additional value of gadoxetic acid-enhanced MRI to conventional extracellular gadolinium-enhanced MRI for the surgical management of colorectal and neuroendocrine liver metastases. HPB (Oxford). 2020;22(5):710–5. https://doi.org/10.1016/j.hpb.2019.09.009. This articles highlights the benefit of contrast enhanced MRI for detection of NET liver metastases.

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Yang J, Kan Y, Ge BH, Yuan L, Li C, Zhao W. Diagnostic role of Gallium-68 DOTATOC and Gallium-68 DOTATATE PET in patients with neuroendocrine tumors: a meta-analysis. Acta Radiol. 2014;55(4):389–98.

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Jackson T, Darwish M, Cho E, Nagatomo K, Osman H, Jeyarajah DR. 68Ga-DOTATATE PET/CT compared to standard imaging in metastatic neuroendocrine tumors: a more sensitive test to detect liver metastasis? Abdom Radiol (NY). 2021;46(7):3179–3183. https://doi.org/10.1007/s00261-021-02990-4.

Zhang P, Yu J, Li J, Shen L, Li N, Zhu H, Zhai S, Zhang Y, Yang Z, Lu M. Clinical and Prognostic Value of PET/CT Imaging with combination of 68Ga-DOTATATE and 18F-FDG in Gastroenteropancreatic Neuroendocrine neoplasms. Contrast Media Mol Imaging. 2018;2018:2340389. https://doi.org/10.1155/2018/2340389.

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Abgral R, Leboulleux S, Déandreis D, Aupérin A, Lumbroso J, Dromain C, Duvillard P, Elias D, de Baere T, Guigay J, Ducreux M, Schlumberger M, Baudin E. Performance of (18)fluorodeoxyglucose-positron emission tomography and somatostatin receptor scintigraphy for high Ki67 (≥ 10%) well-differentiated endocrine carcinoma staging. J Clin Endocrinol Metab. 2011;96(3):665–71.

• Frilling A, Li J, Malamutmann E, Schmid KW, Bockisch A, Broelsch CE. Treatment of liver metastases from neuroendocrine tumours in relation to the extent of hepatic disease. Br J Surg. 2009;96(2):175 – 84. https://doi.org/10.1002/bjs.6468. This was the first article to delineate a classification for liver metastases to aid in determining when to consider liver surgery.

Mahuron KM, Singh G. Defining a new classification system for the Surgical Management of Neuroendocrine Tumor Liver metastases. J Clin Med. 2023;12(7):2456. https://doi.org/10.3390/jcm12072456.

• Schreckenbach T, Hübert H, Koch C, Bojunga J, Schnitzbauer AA, Bechstein WO, Holzer K. Surgical resection of neuroendocrine tumor liver metastases as part of multimodal treatment strategies: A propensity score matching analysis. Eur J Surg Oncol. 2019;45(5):808–815. doi: 10.1016/j.ejso.2018.12.022. This study demonstrates that surgical resection does not necessarily improve overall survival in patients with metastatic NET. Suggesting careful selection of whom to operate on is important to improve long term outcomes.

Norlén O, Stålberg P, Zedenius J, Hellman P. Outcome after resection and radiofrequency ablation of liver metastases from small intestinal neuroendocrine tumours. Br J Surg. 2013;100(11):1505-14. https://doi.org/10.1002/bjs.9262.

Inoue Y, Kagota S, Tsuchimoto Y, Ogura T, Asai A, Fukunishi S, Higuchi K, Uchiyama K. Laparoscopic liver resection for patients with cardiac disease. Contemp Oncol (Pozn). 2019;23(1):37–42. https://doi.org/10.5114/wo.2019.84109.

Juhlin CC, Zedenius J, Höög A. Metastatic neuroendocrine neoplasms of unknown primary: clues from Pathology Workup. Cancers (Basel). 2022;14(9):2210. https://doi.org/10.3390/cancers14092210.

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Cloyd JM, Ejaz A, Konda B, Makary MS, Pawlik TM. Neuroendocrine liver metastases: a contemporary review of treatment strategies. Hepatobiliary Surg Nutr. 2020;9(4):440–51. https://doi.org/10.21037/hbsn.2020.04.02.

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Kaçmaz E, Heidsma CM, Besselink MGH, Dreijerink KMA, Klümpen HJ, van Nieveen EJM, Engelsman AF. Treatment of Liver metastases from Midgut Neuroendocrine tumours: a systematic review and Meta-analysis. J Clin Med. 2019;8(3):403. https://doi.org/10.3390/jcm8030403.

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Saxena A, Chua TC, Perera M, Chu F, Morris DL. Surgical resection of hepatic metastases from neuroendocrine neoplasms: a systematic review. Surg Oncol. 2012;21(3):e131–41. https://doi.org/10.1016/j.suronc.2012.05.001.

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Chambers AJ, Pasieka JL, Dixon E, Rorstad O. The palliative benefit of aggressive surgical intervention for both hepatic and mesenteric metastases from neuroendocrine tumors. Surgery. 2008;144(4):645 – 51; discussion 651-3. https://doi.org/10.1016/j.surg.2008.06.008.

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• Maxwell JE, Sherman SK, O’Dorisio TM, Bellizzi AM, Howe JR. Liver-directed surgery of neuroendocrine metastases: What is the optimal strategy? Surgery. 2016;159(1):320 – 33. https://doi.org/10.1016/j.surg.2015.05.040. This study demonstrated elegantly that using a lower threshold for considering liver resection may still be beneficial, rather than a debulking cut-off of > 90% being considered.

Scott AT, Breheny PJ, Keck KJ, Bellizzi AM, Dillon JS, O’Dorisio TM, Howe JR. Effective cytoreduction can be achieved in patients with numerous neuroendocrine tumor liver metastases (NETLMs). Surgery. 2019;165(1):166–75. https://doi.org/10.1016/j.surg.2018.04.070.

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Bell RJ, Hakeem AR, Pandanaboyana S, Davidson BR, Prasad RK, Dasari BVM. Portal vein embolization versus dual vein embolization for management of the future liver remnant in patients undergoing major hepatectomy: meta-analysis. BJS open. 2022;6(6):zrac131. https://doi.org/10.1093/bjsopen/zrac131.

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Müller PC, Pfister M, Eshmuminov D, Lehmann K. Liver transplantation versus liver resection for treatment of neuroendocrine liver metastasis: Appraisal of the current evidence. Hepatobiliary Pancreat Dis Int. 2023 Aug 12:S1499-3872(23)00126-1. https://doi.org/10.1016/j.hbpd.2023.08.007. A critical review of liver transplant vs. surgical management for liver metastases in patients with NETs.

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Le Treut YP, Grégoire E, Klempnauer J, Belghiti J, Jouve E, Lerut J, Castaing D, Soubrane O, Boillot O, Mantion G, Homayounfar K, Bustamante M, Azoulay D, Wolf P, Krawczyk M, Pascher A, Suc B, Chiche L, de Urbina JO, Mejzlik V, Pascual M, Lodge JP, Gruttadauria S, Paye F, Pruvot FR, Thorban S, Foss A, Adam R, For ELITA. Liver transplantation for neuroendocrine tumors in Europe-results and trends in patient selection: a 213-case European liver transplant registry study. Ann Surg. 2013;257(5):807 – 15. https://doi.org/10.1097/SLA.0b013e31828ee17c.

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