Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Aug;12(6):427-33.
doi: 10.1111/j.1477-2574.2010.00198.x.

Long-term survival after surgical management of neuroendocrine hepatic metastases

Evan S Glazer  1 , Jennifer F Tseng, Waddah Al-Refaie, Carmen C Solorzano, Ping Liu, Katherine A Willborn, Eddie K Abdalla, Jean-Nicolas Vauthey, Steven A Curley
Affiliations

Long-term survival after surgical management of neuroendocrine hepatic metastases

Evan S Glazer et al. HPB (Oxford). 2010 Aug.

Abstract

Background: Surgical cytoreduction and endocrine blockade are important options for care for neuroendocrine liver metastases. We investigated the long-term survival of patients surgically treated for hepatic neuroendocrine metastases.

Methods: Patients (n= 172) undergoing operations for neuroendocrine liver metastases from any primary were identified from a prospective liver database. Recorded data and medical record review were used to analyse the type of procedure, length of hospital stay, peri-operative morbidity, tumour recurrence, progression,and survival.

Results: The median age was 56.8 years (range 11.5-80.7 years). 48.3% of patients were female. Median overall survival was 9.6 years (range 89 days to 22 years). On multivariate analysis, lung/thymic primaries were associated with worse survival [hazard ratio (HR): 15.6, confidence interval (CI): 4.3-56.8, P= 0.002]. Severe post-operative complications were also associated with worse long-term survival (P < 0.001). A positive resection margin status (R1) was not associated with a worse overall survival probability (P approximately 0.8).

Discussion: Early and aggressive surgical management of hepatic metastases from neuroendocrine tumours is associated with significant long-term survival rates. Radiofrequency ablation is a reasonable option if a lesion is unresectable. R1 resections, unlike many other cancers, are not associated with a worse overall survival.

PubMed Disclaimer

Figures

Figure 2
Figure 2
Although peri-operative complications seem to be associated with decreased long-term overall survival, this did not reach statistical significance. Furthermore, there is no discernable difference for the first 8 years after surgical treatment
Figure 1
Figure 1
Patients with surgically treated isolated hepatic metastatic neuroendocrine tumours (NET) have very good long-term overall survival. In addition, the few patients with unknown primaries did extremely well after surgery. However, primary lesions in the thorax (lung and thymus) did strikingly poorly after resection. These small numbers do not permit accurate generalizations as to the cause of this phenomenon. As deaths are from any cause in the overall survival analysis, it is possible that the primary resection (i.e. lung resection) contributed to long-term morbidity and mortality
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Modlin IM, Sandor A, Tang LH, Kidd M, Zelterman D. A 40-year analysis of 265 gastric carcinoids. Am J Gastroenterol. 1997;92:633–638. - PubMed
    1. Ahmed A, Turner G, King B, Jones L, Culliford D, McCance D, et al. Midgut neuroendocrine tumours with liver metastases: results of the UKINETS study. Endocr Relat Cancer. 2009;16:885–894. - PubMed
    1. Zeegen R, Rothwell-Jackson R, Sandler M. Massive hepatic resection for the carcinoid syndrome. Gut. 1969;10:617–622. - PMC - PubMed
    1. Landry CS, Scoggins CR, McMasters KM, Martin RC., 2nd Management of hepatic metastasis of gastrointestinal carcinoid tumors. J Surg Oncol. 2008;97:253–258. - PubMed
    1. Hill JS, McPhee JT, McDade TP, Zhou Z, Sullivan ME, Whalen GF, et al. Pancreatic neuroendocrine tumors: the impact of surgical resection on survival. Cancer. 2009;115:741–751. - PubMed

Publication types

MeSH terms