Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 24:16:1601185.
doi: 10.3389/fendo.2025.1601185. eCollection 2025.

Management of liver metastases from non-functional gastroenteropancreatic neuroendocrine tumors: a systematic review

Jun-Shuai Xue  1 , Yi Yang  1 , Zhen Huang  1 , Hong Zhao  1 , Xiao Chen #  1 , Jian-Qiang Cai #  1
Affiliations

Management of liver metastases from non-functional gastroenteropancreatic neuroendocrine tumors: a systematic review

Jun-Shuai Xue et al. Front Endocrinol (Lausanne). .

Abstract

The liver is the most common metastatic organ of neuroendocrine tumors (NETs). NET liver metastases (NETLMs) are categorized into simple liver metastasis (type I), complex liver metastasis (type II) and diffuse liver metastasis (type III), of which diffuse liver metastasis accounts for the highest percentage, up to 60-70%. Radical resection is recommended for all patients with type I and partial type II liver metastases without extrahepatic metastases in G1 and G2 grades, with a 5-year survival rate of 65%-70%. But for patients with G3 or type III liver metastases, treatment is controversial. Ablation and TAE/TACE are commonly used localized treatments. Somatostatin analogue (octreotide and lanreotide) are efficacious in the treatment of better-differentiated NETs and can prolong the progression-free survival (PFS) of patients. Targeted drugs such as sunitinib, everolimus, sofantinib and cabozantinib are used to control tumor growth and improve symptoms. In addition, peptide receptor radionuclide therapy (PRRT), has been approved by the FDA for the treatment of progressive somatostatin receptor-positive gastroenteropancreatic NETs and has shown potential for prolonging PFS and improving survival. Multidisciplinary treatment is crucial for patients with NETLMs with high tumor load, and neoadjuvant therapy combined with surgery may lead to a better prognosis. However, the choice of treatment, indications for combination therapy, and disease prognosis still require further research and exploration. This review summarizes and evaluates the current treatment strategies and development trend of NETLM treatment through a literature review and provides new ideas as well as insights.

Keywords: gastroenteropancreatic neuroendocrine tumors; liver metastasis; multidiscipline; review; treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The treatment and indications for NETLM patients.
Figure 2
Figure 2
The flow chart of screening for studies.
Figure 3
Figure 3
The diagram of the proposed treatments for NETLM.
See this image and copyright information in PMC

References

    1. Frilling A, Modlin IM, Kidd M, Russell C, Breitenstein S, Salem R, et al. Recommendations for management of patients with neuroendocrine liver metastases. Lancet Oncol. (2014) 15:e8–21. doi: 10.1016/S1470-2045(13)70362-0, PMID: - DOI - PubMed
    1. Shah MH, Goldner WS, Benson AB, Bergsland E, Blaszkowsky LS, Brock P, et al. Neuroendocrine and adrenal tumors, version 2.2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. (2021) 19:839–68. doi: 10.6004/jnccn.2021.0032, PMID: - DOI - PubMed
    1. Rizen EN, Phan AT. Neuroendocrine tumors: a relevant clinical update. Curr Oncol Rep. (2022) 24:703–14. doi: 10.1007/s11912-022-01217-z, PMID: - DOI - PubMed
    1. Dasari A, Shen C, Halperin D, Zhao B, Zhou S, Xu Y, et al. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol. (2017) 3:1335–42. doi: 10.1001/jamaoncol.2017.0589, PMID: - DOI - PMC - PubMed
    1. Rindi G, Mete O, Uccella S, Basturk O, La Rosa S, Brosens LAA, et al. Overview of the 2022 WHO classification of neuroendocrine neoplasms. Endocr Pathol. (2022) 33:115–54. doi: 10.1007/s12022-022-09708-2, PMID: - DOI - PubMed

Publication types

MeSH terms

Supplementary concepts

LinkOut - more resources