Management of hepatic metastases of well/moderately differentiated neuroendocrine tumors of the digestive tract  

作　　者：Anna La Salvia Stefano Partelli Marco Tampellini Domenico Tamburrino Massimo Falconi Giorgio V.Scagliotti Maria Pia Brizzi 

机构地区：[1]Division of Medical Oncology,Department of Oncology,University of Turin,San Luigi Gonzaga Hospital,Regione Gonzole 10,10043 Orbassano,Italy [2]Pancreatic Surgery Unit,San Raffaele Hospital,Vita-Salute San Raffaele University,20132 Milan,Italy [3]HPB Unit,Royal Free Hospital,London NW32QG,UK

出　　处：《Journal of Cancer Metastasis and Treatment》2016年第1期294-303,共10页癌症转移与治疗（英文版）

摘　　要：In neuroendocrine tumors(NETs),liver metastases(LM)represent the most crucial prognostic factor,irrespective of the primary tumor site.At diagnosis,about 65-95%of gastroenteropancreatic neuroendocrine tumors(GEP-NETs)show hepatic metastasis.Management strategies of LM are heterogeneous and range from systemic therapy to liver-directed procedures.The type of systemic therapy used is dependent on the grade and proliferation of the tumor and includes somatostatin analogues,interferon,m-Tor and tyrosine kinase inhibitors,and chemotherapy.Angiographic liver-directed techniques,such as transarterial embolization/chemoembolization and selective internal radiation therapy,offer excellent palliation for patients with liver-predominant disease.In highly selected cases,liver transplantation and peptide receptor radionuclide therapy are considered.The relatively low disease incidence and the diversity of presentation have led to a lack of well-conducted randomized controlled trials comparing the efficacy of different treatment options.Experience indicates that surgery is the only treatment that offers potential for cure.For unresectable lesions,the absence of data from rigorous trials limits the validity of many publications that detail management.In this review we will discuss the existing approaches for hepatic metastases from GEP-NETs.

关 键 词：Gastroenteropancreatic carcinoids METASTASES systemic treatment 

分 类 号：R73[医药卫生—肿瘤]