Liver Transplantation for Metastatic Neuroendocrine Tumors

The ideal management of NET must be addressed on a case-by-case basis, with consideration given to patient factors, disease burden, and clinical tumor activity. Outcome improvement for LT in the setting of metastatic disease requires better characterization of the biological behavior of NETs and fur...

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Bibliographic Details
Published in:Advances in surgery (Chicago) 2014, Vol.48 (1), p.235-252
Main Authors: Chung, Haniee, MD, Chapman, William C., MD, FACS
Format: Article
Language:English
Subjects:
Biomarkers, Tumor - blood
Carcinoid
Diagnostic Imaging
Gastrointestinal Neoplasms - classification
Gastrointestinal Neoplasms - epidemiology
Gastrointestinal Neoplasms - pathology
Gastrointestinal Neoplasms - surgery
Humans
Incidence
Islet cell tumors
Liver metastases
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Liver Transplantation
Liver transplantation for malignancy
Neoplasm Staging
Neuroendocrine tumors
Neuroendocrine Tumors - classification
Neuroendocrine Tumors - epidemiology
Neuroendocrine Tumors - secondary
Neuroendocrine Tumors - surgery
Pancreatic Neoplasms - classification
Pancreatic Neoplasms - epidemiology
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Surgery
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Description
Summary:The ideal management of NET must be addressed on a case-by-case basis, with consideration given to patient factors, disease burden, and clinical tumor activity. Outcome improvement for LT in the setting of metastatic disease requires better characterization of the biological behavior of NETs and further identification of factors to be included in the selection criteria. Box 3 summarizes the many areas that have been, and are currently, undergoing investigation. LT as an attempt for cure rather than palliation is a justified treatment option for well-selected patients with metastatic neuroendocrine tumors of the pancreas and GI system. Optimization of pretransplantation staging and patient management algorithms, patient selection, and posttransplant management options are areas that need to be better defined. Further investigations for defining reproducible prognostic factors, consistent histopathologic evaluation, and uniform preoperative staging and site-specific data are needed. With the advancement of newer treatment modalities, it is necessary to define the role of LT along with the optimal perioperative management of existing and recurrent disease.
ISSN:0065-3411
1878-0555
DOI:10.1016/j.yasu.2014.05.003