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.
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...
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.
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...
#1Heather A. Farley(OHSU: Oregon Health & Science University)H-Index: 2
#2Rodney F. Pommier(OHSU: Oregon Health & Science University)H-Index: 38
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...
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...
Aim To determine the benefits and risks of hepatic resection versus non-resectional liver-directed treatments in patients with potentially resectable neuroendocrine liver metastases.
Last. London L.P.J. Ooi(NUS: National University of Singapore)H-Index: 57
view all 4 authors...
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...
#1Evan S. Glazer(University of Texas MD Anderson Cancer Center)H-Index: 19
#2Jennifer F. Tseng(UMMS: University of Massachusetts Medical School)H-Index: 57
Last. Steven A. Curley(University of Texas MD Anderson Cancer Center)H-Index: 98
view all 9 authors...
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 ...
Neuroendocrine tumors (NETs) arise in most organs of the body and share many common pathologic features. However, a variety of different organ-specific systems have been developed for nomenclature, grading, and staging of NETs, causing much confusion. This review examines issues in the pathologic assessment of NETs that are common among primaries of different sites. The various systems of nomenclature are compared along with new proposal for grading and staging NETs. Although differences persist...
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,...
Background Neuroendocrine neoplasia of the small intestine (siNEN) are frequently diagnosed with liver metastases. The impact of the presence of liver metastases on overall survival and the necessity of surgery for liver metastasis is discussed controversially. The aim of this study is to evaluate and compare the overall long-term survival of patients with siNENs with and without liver metastasis at initial diagnosis and the possible benefit of surgical treatment as compared to active surveillan...
Palliative care is the multidisciplinary focus on patient symptoms with the goal of preservation or improvement in quality of life. Given the indolent nature of well-differentiated neuroendocrine tumors (NETs) and the long life expectancy experienced by patients with NETs, even advanced metastatic disease, careful consideration of symptom control and quality of life is of the upmost importance. This chapter will review the indications for, patient selection for, and outcomes of palliative surger...
ABSTRACT Hepatic neuroendocrine tumors (HNETs) are uncommon neoplasms that can be subdivided into 2 types: primary and metastatic HNETs. Due to its rarity, heterogeneity and complexity, the diagnosis, treatment modalities and prognosis are still controversial.This retrospective study reviewed the effects of tumor origins and therapeutic options on the prognosis of gastroenteropancreatic neuroendocrine tumors with liver metastasis (GEP-NETLM) and primary hepatic neuroendocrine tumors (PHNETs), pr...
Over the past 5 years, a number of notable research advances have been made in the field of neuroendocrine cancer, specifically with regard to neuroendocrine cancer of the gastrointestinal tract. The aim of this Review is to provide an update on current knowledge that has proven effective for the clinical management of patients with these tumours. For example, for the first time in the tubular gastrointestinal tract, well-differentiated high-grade (grade 3) tumours and mixed neuroendocrine–non-n...
#1Rongzhi Wang(UAB: University of Alabama at Birmingham)H-Index: 2
#2Rui Zheng-Pywell(UAB: University of Alabama at Birmingham)H-Index: 1
Last. J. Bart Rose(UAB: University of Alabama at Birmingham)H-Index: 8
view all 6 authors...
Neuroendocrine neoplasms (NENs) are derived from neuroendocrine cell system and can have benign or malignant characteristics. They are rare tumors, but have been increasing in incidence over the pa...
BACKGROUND: Survival benefit of liver resection for noncolorectal liver metastases (NCRLM) remains to be defined. METHODS: This multicenter, retrospective cohort analysis included consecutive patients with NCRLM whose primary tumor and all metastases were treated with curative intent between 2000 and 2013. The primary endpoint was 5-year overall survival. Clinicopathological factors that affected prognoses were identified using multivariate Cox regression analyses and were included in a predicti...
#2Alex B. Blair(JHUSOM: Johns Hopkins University School of Medicine)H-Index: 17
Last. Jin He(JHUSOM: Johns Hopkins University School of Medicine)H-Index: 40
view all 12 authors...
Abstract Background The literature suggests favorable survival for patients with isolated pulmonary recurrence after resection of pancreatic ductal adenocarcinoma (PDAC) as compared to other recurrence patterns. Within this cohort, it remains unclear what factors are associated with improved survival. Methods Patients who developed pulmonary recurrence after pancreatectomy were selected from a prospective database. Predictors for post-recurrence survival (PRS) were analyzed using a multivariable...
#1Chaobin He(SYSU: Sun Yat-sen University)H-Index: 11
#2Yu Zhang(SYSU: Sun Yat-sen University)H-Index: 10
Last. Xiaojun Lin(SYSU: Sun Yat-sen University)H-Index: 21
view all 4 authors...
: Aim The role of surgery in the treatment of metastatic pancreatic neuroendocrine tumors (PNETs) was controversial. The objectives of this study were to illustrate the impact of surgery in improving the prognosis of patients with metastatic PNETs and build nomograms to predict overall survival (OS) and cancer-specific survival (CSS) based on a large population-based cohort. Methods Patients diagnosed with metastatic PNETs between 2004 and 2015 from the Surveillance, Epidemiology, and End Result...