Effective cytoreduction can be achieved in patients with numerous neuroendocrine tumor liver metastases (NETLMs)
AT Scott, PJ Breheny, KJ Keck, AM Bellizzi, JS Dillon…�- Surgery, 2019 - Elsevier
AT Scott, PJ Breheny, KJ Keck, AM Bellizzi, JS Dillon, TM O'Dorisio, JR Howe
Surgery, 2019•ElsevierBackground Cytoreductive surgery for neuroendocrine tumor liver metastases improves
survival and symptomatic control. However, the feasibility of adequate cytoreduction in
patients with many liver metastases remains uncertain. We compared patient outcomes
based on the number of lesions treated to better define the efficacy of cytoreductive surgery
for numerous neuroendocrine tumor liver metastases. Methods Patients undergoing hepatic
cytoreductive surgery for gastroenteropancreatic neuroendocrine tumors were identified in�…
survival and symptomatic control. However, the feasibility of adequate cytoreduction in
patients with many liver metastases remains uncertain. We compared patient outcomes
based on the number of lesions treated to better define the efficacy of cytoreductive surgery
for numerous neuroendocrine tumor liver metastases. Methods Patients undergoing hepatic
cytoreductive surgery for gastroenteropancreatic neuroendocrine tumors were identified in�…
Background
Cytoreductive surgery for neuroendocrine tumor liver metastases improves survival and symptomatic control. However, the feasibility of adequate cytoreduction in patients with many liver metastases remains uncertain. We compared patient outcomes based on the number of lesions treated to better define the efficacy of cytoreductive surgery for numerous neuroendocrine tumor liver metastases.
Methods
Patients undergoing hepatic cytoreductive surgery for gastroenteropancreatic neuroendocrine tumors were identified in our institutional surgical neuroendocrine tumor database. Imaging studies were reviewed to determine the liver tumor burden and percent cytoreduced. Overall survival and progression-free survival were compared, using the number of lesions treated, percent tumor debulked, and additional clinicopathologic characteristics.
Results
A total of 188 hepatic cytoreductive procedures were identified and stratified into groups according to the number of metastases treated: 1–5, 6–10, and >10. Median overall survival and progression-free survival were 89.4 and 22.5 months, respectively, and did not differ significantly between groups. Greater than 70% cytoreduction was associated with significantly better overall survival than <70% cytoreduction (134 months versus 38 months).
Conclusion
In patients with gastroenteropancreatic neuroendocrine tumors and liver metastases, >70% cytoreduction led to improved overall survival and progression-free survival and was achieved reliably in patients undergoing debulking of >10 lesions. These data support an aggressive approach to patients with numerous neuroendocrine tumor liver metastases to achieve >70% cytoreduction.
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