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Practice Guideline
. 2015 Jan;17(1):17-22.
doi: 10.1111/hpb.12225. Epub 2014 Mar 17.

When should a liver resection be performed in patients with liver metastases from neuroendocrine tumours? A systematic review with practice recommendations

Mickaël Lesurtel  1 , David M Nagorney, Vincenzo Mazzaferro, Robert T Jensen, Graeme J Poston
Affiliations
Practice Guideline

When should a liver resection be performed in patients with liver metastases from neuroendocrine tumours? A systematic review with practice recommendations

Mickaël Lesurtel et al. HPB (Oxford). 2015 Jan.

Abstract

Aim: To determine the benefits and risks of hepatic resection versus non-resectional liver-directed treatments in patients with potentially resectable neuroendocrine liver metastases.

Methods: A systematic review identified 1594 reports which alluded to a possible liver resection for neuroendocrine tumour metastases, of which 38 reports (all retrospective), comprising 3425 patients, were relevant.

Results: Thirty studies reported resection alone, and 16 studies reported overall survival (OS). Only two studies addressed quality-of-life (QoL) issues. Five-year overall survival was reported at 41-100%, whereas 5-year progression-free survival (PFS) was 5-54%. We identified no robust evidence that a liver resection was superior to any other liver-directed therapies in improving OS or PFS. There was no evidence to support the use of a R2 resection (debulking), with or without tumour ablation, to improve either OS or QoL. There was little evidence to guide sequencing of surgery for patients presenting in Stage IV with resectable disease, and none to support a resection of asymptomatic primary tumours in the presence of non-resectable liver metastases.

Conclusion: Low-level recommendations are offered to assist in the management of patients with neuroendocrine liver metastases, along with recommendations for future studies.

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Figures

Figure 1
Figure 1
PRISMA (preferred reporting items for systematic reviews and meta-analyses) flow chart showing selection of the studies for review
See this image and copyright information in PMC

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