Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas: A surgeon's plea to centering attention on the liver

Xavier M. Keutgen, Erik Schadde, Rodney F. Pommier, Thorvardur R Halfdanarson, James R. Howe, Electron Kebebew

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

Over 50% of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have stage IV disease at presentation and the most likely organ to be affected by metastases is the liver. Hepatic involvement and hepatic tumor burden is a key prognostic factor affecting survival of these patients and 80% eventually die of liver failure due to tumor dissemination within the liver. This commentary explores the efficacy and limitations of systemic treatments in patients with GEP-NETs and liver metastases. Landmark randomized trials using systemic therapies including sandostatin (PROMID), lanreotide (CLARINET), everolimus (RADIANT 3 and 4), sunitinib and Peptide Receptor Radionuclide Therapy (NETTER-1) have not shown efficacy in reducing liver tumor burden in patients with stage IV GEP-NETs with liver metastases as outlined in this review. Although often overlooked, surgical debulking has been associated with a significant survival advantage in large retrospective studies and in our opinion should remain an important therapeutic option for patients with stage IV GEP-NETs and liver metastases.

Original languageEnglish (US)
Pages (from-to)232-235
Number of pages4
JournalSeminars in oncology
Volume45
Issue number4
DOIs
StatePublished - Aug 1 2018

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Keywords

  • Liver metastases
  • Liver resection
  • Neuroendocrine tumor
  • Systemic therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology

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