Abstract
Background: The role of liver transplant (LT) for neuroendocrine liver metastasis (NELM) has not been completely defined. While international guidelines included LT as a potential treatment for highly selected patients with advanced NELM, recently, LT has been proposed as an alternative curative treatment for NELM for patients meeting restrictive criteria (Milan criteria). Methods: Using a multi-institutional cohort of patients undergoing liver resection for NELM, the long-term outcomes of patients meeting Milan criteria (resected NET drained by the portal system, stable disease/response to therapies for at least 6 months, metastatic diffusion to < 50% of the total liver volume, a confirmed histology of low-grade, and ≤ 60 years) were investigated. Results: Among the 238 patients included in the study, 28 (12%) patients met the Milan criteria for LT with a 5-year OS of 83%. Furthermore, among patients meeting Milan criteria, subsets of patients with favorable clinic-pathological characteristics had 5-year OS rates greater than 90% including G1 patients (5-year OS, 92%), patients undergoing minor liver resection (5-year OS, 94%), patients with low number of NELM (1–2 NELM), and small tumor size (< 3 cm) (for both groups of patients, 5-year OS, 100%). Conclusions: In our series, only 12% of patients met Milan criteria, and the 5-year OS after liver resection for this small selected group of patients was comparable with that reported in the literature for patients undergoing LT for NELM within Milan criteria. While LT might be the optimal treatment for patients with unresectable NELM, surgical resection should be the first option for patients with resectable NELM.
| Original language | English |
|---|---|
| Pages (from-to) | 93-100 |
| Number of pages | 8 |
| Journal | Journal of Gastrointestinal Surgery |
| Volume | 23 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 15 2018 |
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Keywords
- Liver surgery
- Liver transplant
- Neuroendocrine liver metastasis
ASJC Scopus subject areas
- Surgery
- Gastroenterology
Cite this
Liver Resection for Neuroendocrine Tumor Liver Metastases Within Milan Criteria for Liver Transplantation. / Ruzzenente, Andrea; Bagante, Fabio; Bertuzzo, Francesca; Aldrighetti, Luca; Campagnaro, Tommaso; Ercolani, Giorgio; Conci, Simone; Giuliante, Felice; Dore, Andrea; Ferrero, Alessandro; Torzilli, Guido; Grazi, Gian Luca; Ratti, Francesca; Cucchetti, Alessandro; De Rose, Agostino M.; Russolillo, Nadia; Cimino, Matteo; Perri, Pasquale; Guglielmi, Alfredo; Iacono, Calogero.
In: Journal of Gastrointestinal Surgery, Vol. 23, No. 1, 15.01.2018, p. 93-100.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Liver Resection for Neuroendocrine Tumor Liver Metastases Within Milan Criteria for Liver Transplantation
AU - Ruzzenente, Andrea
AU - Bagante, Fabio
AU - Bertuzzo, Francesca
AU - Aldrighetti, Luca
AU - Campagnaro, Tommaso
AU - Ercolani, Giorgio
AU - Conci, Simone
AU - Giuliante, Felice
AU - Dore, Andrea
AU - Ferrero, Alessandro
AU - Torzilli, Guido
AU - Grazi, Gian Luca
AU - Ratti, Francesca
AU - Cucchetti, Alessandro
AU - De Rose, Agostino M.
AU - Russolillo, Nadia
AU - Cimino, Matteo
AU - Perri, Pasquale
AU - Guglielmi, Alfredo
AU - Iacono, Calogero
PY - 2018/1/15
Y1 - 2018/1/15
N2 - Background: The role of liver transplant (LT) for neuroendocrine liver metastasis (NELM) has not been completely defined. While international guidelines included LT as a potential treatment for highly selected patients with advanced NELM, recently, LT has been proposed as an alternative curative treatment for NELM for patients meeting restrictive criteria (Milan criteria). Methods: Using a multi-institutional cohort of patients undergoing liver resection for NELM, the long-term outcomes of patients meeting Milan criteria (resected NET drained by the portal system, stable disease/response to therapies for at least 6 months, metastatic diffusion to < 50% of the total liver volume, a confirmed histology of low-grade, and ≤ 60 years) were investigated. Results: Among the 238 patients included in the study, 28 (12%) patients met the Milan criteria for LT with a 5-year OS of 83%. Furthermore, among patients meeting Milan criteria, subsets of patients with favorable clinic-pathological characteristics had 5-year OS rates greater than 90% including G1 patients (5-year OS, 92%), patients undergoing minor liver resection (5-year OS, 94%), patients with low number of NELM (1–2 NELM), and small tumor size (< 3 cm) (for both groups of patients, 5-year OS, 100%). Conclusions: In our series, only 12% of patients met Milan criteria, and the 5-year OS after liver resection for this small selected group of patients was comparable with that reported in the literature for patients undergoing LT for NELM within Milan criteria. While LT might be the optimal treatment for patients with unresectable NELM, surgical resection should be the first option for patients with resectable NELM.
AB - Background: The role of liver transplant (LT) for neuroendocrine liver metastasis (NELM) has not been completely defined. While international guidelines included LT as a potential treatment for highly selected patients with advanced NELM, recently, LT has been proposed as an alternative curative treatment for NELM for patients meeting restrictive criteria (Milan criteria). Methods: Using a multi-institutional cohort of patients undergoing liver resection for NELM, the long-term outcomes of patients meeting Milan criteria (resected NET drained by the portal system, stable disease/response to therapies for at least 6 months, metastatic diffusion to < 50% of the total liver volume, a confirmed histology of low-grade, and ≤ 60 years) were investigated. Results: Among the 238 patients included in the study, 28 (12%) patients met the Milan criteria for LT with a 5-year OS of 83%. Furthermore, among patients meeting Milan criteria, subsets of patients with favorable clinic-pathological characteristics had 5-year OS rates greater than 90% including G1 patients (5-year OS, 92%), patients undergoing minor liver resection (5-year OS, 94%), patients with low number of NELM (1–2 NELM), and small tumor size (< 3 cm) (for both groups of patients, 5-year OS, 100%). Conclusions: In our series, only 12% of patients met Milan criteria, and the 5-year OS after liver resection for this small selected group of patients was comparable with that reported in the literature for patients undergoing LT for NELM within Milan criteria. While LT might be the optimal treatment for patients with unresectable NELM, surgical resection should be the first option for patients with resectable NELM.
KW - Liver surgery
KW - Liver transplant
KW - Neuroendocrine liver metastasis
UR - http://www.scopus.com/inward/record.url?scp=85053815607&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053815607&partnerID=8YFLogxK
U2 - 10.1007/s11605-018-3973-9
DO - 10.1007/s11605-018-3973-9
M3 - Article
C2 - 30242647
AN - SCOPUS:85053815607
VL - 23
SP - 93
EP - 100
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
SN - 1091-255X
IS - 1
ER -