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

1 Citation (Scopus)

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

Fingerprint

Neuroendocrine Tumors
Gastrointestinal Tract
Pancreas
Liver
Neoplasm Metastasis
Tumor Burden
Octreotide
Peptide Receptors
Survival
Surgeons
Liver Failure
Therapeutics
Radioisotopes
Retrospective Studies
Gastro-enteropancreatic neuroendocrine tumor

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas : A surgeon's plea to centering attention on the liver. / Keutgen, Xavier M.; Schadde, Erik; Pommier, Rodney F.; Halfdanarson, Thorvardur R; Howe, James R.; Kebebew, Electron.

In: Seminars in oncology, Vol. 45, No. 4, 01.08.2018, p. 232-235.

Research output: Contribution to journalReview article

Keutgen, Xavier M. ; Schadde, Erik ; Pommier, Rodney F. ; Halfdanarson, Thorvardur R ; Howe, James R. ; Kebebew, Electron. / Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas : A surgeon's plea to centering attention on the liver. In: Seminars in oncology. 2018 ; Vol. 45, No. 4. pp. 232-235.
@article{88839aeaeda94c3bb97d1792663625ce,
title = "Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas: A surgeon's plea to centering attention on the liver",
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.",
keywords = "Liver metastases, Liver resection, Neuroendocrine tumor, Systemic therapy",
author = "Keutgen, {Xavier M.} and Erik Schadde and Pommier, {Rodney F.} and Halfdanarson, {Thorvardur R} and Howe, {James R.} and Electron Kebebew",
year = "2018",
month = "8",
day = "1",
doi = "10.1053/j.seminoncol.2018.07.002",
language = "English (US)",
volume = "45",
pages = "232--235",
journal = "Seminars in Oncology",
issn = "0093-7754",
publisher = "W.B. Saunders Ltd",
number = "4",

}

TY - JOUR

T1 - Metastatic neuroendocrine tumors of the gastrointestinal tract and pancreas

T2 - A surgeon's plea to centering attention on the liver

AU - Keutgen, Xavier M.

AU - Schadde, Erik

AU - Pommier, Rodney F.

AU - Halfdanarson, Thorvardur R

AU - Howe, James R.

AU - Kebebew, Electron

PY - 2018/8/1

Y1 - 2018/8/1

N2 - 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.

AB - 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.

KW - Liver metastases

KW - Liver resection

KW - Neuroendocrine tumor

KW - Systemic therapy

UR - http://www.scopus.com/inward/record.url?scp=85054562724&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054562724&partnerID=8YFLogxK

U2 - 10.1053/j.seminoncol.2018.07.002

DO - 10.1053/j.seminoncol.2018.07.002

M3 - Review article

C2 - 30318110

AN - SCOPUS:85054562724

VL - 45

SP - 232

EP - 235

JO - Seminars in Oncology

JF - Seminars in Oncology

SN - 0093-7754

IS - 4

ER -