Well-differentiated neuroendocrine tumors(NETs)are globally increasing in prevalence and the liver is the most common site of metastasis.Neuroendocrine liver metastases(NELM)are heterogeneous in clinical presentation ...Well-differentiated neuroendocrine tumors(NETs)are globally increasing in prevalence and the liver is the most common site of metastasis.Neuroendocrine liver metastases(NELM)are heterogeneous in clinical presentation and prognosis.Fortunately,recent advances in diagnostic techniques and therapeutic strategies have improved the multidisciplinary management of this challenging condition.When feasible,surgical resection of NELM offers the best long-term outcomes.General indications for hepatic resection include performance status acceptable for major liver surgery,grade 1 or 2 tumors,absence of extrahepatic disease,adequate size and function of future liver remnant,and feasibility of resecting>90%of metastases.Adjunct therapies including concomitant liver ablation are generally safe when used appropriately and may expand the number of patients eligible for surgery.Among patients with synchronous resectable NELM,resection of the primary either in a staged or combined fashion is recommended.For patients who are not surgical candidates,liver-directed therapies such as transarterial embolization,chemoembolization,and radioembolization can provide locoregional control and improve symptoms of carcinoid syndrome.Multiple systemic therapy options also exist for patients with advanced or progressive disease.Ongoing research efforts are needed to identify novel biomarkers that will define the optimal indications for and sequencing of treatments to be delivered in a personalized fashion.展开更多
Objectives:The aim of this multicenter,prospective,registry study was to summarize the epidemiology of Chinese patients with locally advanced and end-stage gastroenteropancreatic neuroendocrine tumors(GEP-NETs)as well...Objectives:The aim of this multicenter,prospective,registry study was to summarize the epidemiology of Chinese patients with locally advanced and end-stage gastroenteropancreatic neuroendocrine tumors(GEP-NETs)as well as the diagnostic methods and treatment strategies used for these patients.Methods:GEP-NET patients from 11 departments of 8 hospitals in China were prospectively enrolled for a pre-defined period(June 30,2011 to May 29,2012).The patients’demographic,pathological,and treatment data were recorded,analyzed,and released on June 29,2015.Results:Seventy-nine eligible patients were enrolled,and most of these patients were classified according to the World Health Organization 2010 classifications.The most common primary tumor site was the pancreas.The liver was the most common site of metastases,followed by the lymph nodes.The majority of the patients underwent surgical interventions.Patients also received local treatment,medication,or chemotherapy.Conclusion:The pancreas was the most common primary tumor site of locally advanced and end-stage GEP-NETs.Surgical interventions are currently the most common treatment strategy.展开更多
文摘Well-differentiated neuroendocrine tumors(NETs)are globally increasing in prevalence and the liver is the most common site of metastasis.Neuroendocrine liver metastases(NELM)are heterogeneous in clinical presentation and prognosis.Fortunately,recent advances in diagnostic techniques and therapeutic strategies have improved the multidisciplinary management of this challenging condition.When feasible,surgical resection of NELM offers the best long-term outcomes.General indications for hepatic resection include performance status acceptable for major liver surgery,grade 1 or 2 tumors,absence of extrahepatic disease,adequate size and function of future liver remnant,and feasibility of resecting>90%of metastases.Adjunct therapies including concomitant liver ablation are generally safe when used appropriately and may expand the number of patients eligible for surgery.Among patients with synchronous resectable NELM,resection of the primary either in a staged or combined fashion is recommended.For patients who are not surgical candidates,liver-directed therapies such as transarterial embolization,chemoembolization,and radioembolization can provide locoregional control and improve symptoms of carcinoid syndrome.Multiple systemic therapy options also exist for patients with advanced or progressive disease.Ongoing research efforts are needed to identify novel biomarkers that will define the optimal indications for and sequencing of treatments to be delivered in a personalized fashion.
文摘Objectives:The aim of this multicenter,prospective,registry study was to summarize the epidemiology of Chinese patients with locally advanced and end-stage gastroenteropancreatic neuroendocrine tumors(GEP-NETs)as well as the diagnostic methods and treatment strategies used for these patients.Methods:GEP-NET patients from 11 departments of 8 hospitals in China were prospectively enrolled for a pre-defined period(June 30,2011 to May 29,2012).The patients’demographic,pathological,and treatment data were recorded,analyzed,and released on June 29,2015.Results:Seventy-nine eligible patients were enrolled,and most of these patients were classified according to the World Health Organization 2010 classifications.The most common primary tumor site was the pancreas.The liver was the most common site of metastases,followed by the lymph nodes.The majority of the patients underwent surgical interventions.Patients also received local treatment,medication,or chemotherapy.Conclusion:The pancreas was the most common primary tumor site of locally advanced and end-stage GEP-NETs.Surgical interventions are currently the most common treatment strategy.
