Indications and results of liver resection and hepatic chemoembolization for metastatic gastrointestinal neuroendocrine tumors.
Surgery
; 130(4): 677-82; discussion 682-5, 2001 Oct.
Article
in En
| MEDLINE
| ID: mdl-11602899
ABSTRACT
BACKGROUND:
We reviewed 36 patients with liver metastases from islet cell tumors of the pancreas (n = 18) and carcinoid tumors (n = 18) who were treated with surgical resection (n = 16) or hepatic chemoembolization (n = 20).METHODS:
All resections were complete and included 4 lobectomies, 6 segmental resections, and 6 wedge resections. There were no operative deaths.RESULTS:
Median survival has not yet been reached, and the actuarial 5-year survival rate is 70%. Prognostic variables associated with improved disease-free survival included prior resection of the primary tumor and 4 or fewer metastases resected (P <.05). With an average of 3 chemoembolization procedures per patient, 17 of 20 patients (90%) demonstrated either a significant radiographic response (n = 5), stabilization of tumor mass (n = 2), or improvement of clinical symptoms (n = 10). Factors related to a sustained response (more then 1 year) included surgical resection of the primary tumor, 4 or more chemoembolization procedures, and liver metastases of 5 cm or smaller. Median survival after treatment was 32 months (range, 7-63 months), and the actuarial 5-year survival rate was 40%.CONCLUSIONS:
Surgical resection of metastatic neuroendocrine tumors provides the best chance for extended survival. Chemoembolization effectively improves clinical symptoms and, in selected patients, may provide sustained tumor control.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreatic Neoplasms
/
Carcinoid Tumor
/
Chemoembolization, Therapeutic
/
Adenoma, Islet Cell
/
Gastrointestinal Neoplasms
/
Hepatectomy
/
Liver Neoplasms
Type of study:
Prognostic_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Surgery
Year:
2001
Document type:
Article
Affiliation country:
United States