The Impact of Extent of Liver Resection Among Patients with Neuroendocrine Liver Metastasis: an International Multi-institutional Study.

Published on Mar 15, 2019in Journal of Gastrointestinal Surgery2.573
· DOI :10.1007/S11605-018-3862-2
Jonathan G. Sham12
Estimated H-index: 12
(JHUSOM: Johns Hopkins University School of Medicine),
Aslam Ejaz34
Estimated H-index: 34
(JHUSOM: Johns Hopkins University School of Medicine)
+ 11 AuthorsJin He40
Estimated H-index: 40
(JHUSOM: Johns Hopkins University School of Medicine)
Sources
Abstract
Background Liver resection in patients with neuroendocrine liver metastasis (NELM) provides a survival benefit, yet the optimal extent of resection remains unknown. We sought to examine outcomes of patients undergoing non-anatomic (NAR) versus anatomic liver resection (AR) for NELM using a large international cohort of patients.
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Introduction Management of neuroendocrine liver metastasis (NELM) in the presence of extrahepatic disease (EHD) is controversial. We sought to examine outcomes of patients undergoing liver-directed therapy (resection, ablation, or both) for NELM in the presence of EHD using a large international cohort of patients. Methods 612 patients who underwent liver-directed therapy were identified from eight institutions. Postoperative outcomes, as well as and overall (OS) were compared among patients wit...
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Objective:To investigate the potential clinical advantage of anatomical resection versus nonanatomical resection for colorectal liver metastases, according to KRAS mutational status.Background:KRAS-mutated colorectal liver metastases (CRLM) are known to be more aggressive than KRAS wild-type tumors.
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Abstract Background Management of neuroendocrine liver metastasis (NELM) in the setting of unresectable disease is poorly defined and the role of debulking remains controversial. The objective of the current study was to define outcomes following non-curative intent liver-directed therapy (debulking) among patients with NELM. Methods 612 patients were identified who underwent liver-directed therapy of NELM from a multi-institutional database. Outcomes were stratified according to curative (R0/R1...
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Neuroendocrine tumors are rare and slow-growing malignancies that commonly metastasize to the liver, resulting hormonal syndromes and death from liver failure. Surgical consultation and liver debulking are key components in management. Traditional surgical resection guidelines do not apply to these tumors as with other cancers. Surgical resection has shown survival benefit even in the event of an incomplete resection. Ablation may be used as an adjunct to resection or in patients who are not can...
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Abstract Background A large subset of patients with neuroendocrine liver metastasis (NELM) is symptomatic at the time of presentation. In addition to improving survival, treatment of NELM seeks to provide palliation of symptoms. However, data on health-related quality of life (QoL) are uncommon. We sought to define patient-reported QoL after treatment of NELM. Methods Patients who underwent treatment of NELM at Johns Hopkins Hospital between 1998 and 2013 and who were alive as of March 2014 were...
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Management of Neuroendocrine liver metastases (NELM) is challenging. The presence of NELM worsens survival outcome and almost 10% of all liver metastases are neuroendocrine in origin. There is no firm consensus on the optimal treatment strategy for NELM. A systematic search of the PubMed database was performed from 1995–2010, to collate the current evidence and formulate a sound management algorithm. There are 22 case series with a total of 793 patients who had undergone surgery for NELM. The ov...
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Abstract Surgery represents a fundamental component of treatment strategies in neuroendocrine neoplasms. Resection of the primary tumour as well as loco-regional and distant deposits is currently the only modality possessing chance of cure from neuroendocrine neoplasia disease. However, surgical intervention may also have legitimate palliative intents, such as cytoreduction of hormonally active tumour bulk that is not responsive to medical therapy and/or causes local symptoms. In some scenarios,...
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