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Transplantation and Debulking Procedures for Neuroendocrine Tumors
A Frilling1, A Al-Nahhas, A K Clift
1Departments of Surgery and Cancer, Imperial College London, London, UK.
Frontiers of Hormone Research
|August 26, 2015
Summary
Complete surgical resection offers the only cure for neuroendocrine tumors (NETs). For advanced NETs, surgery like debulking or liver transplantation may improve survival and quality of life when carefully selected.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Neuroendocrine tumors (NETs) present diverse management challenges.
- Complete tumor resection is the only curative option, but often not feasible at diagnosis.
- Nonsurgical treatments are advancing, impacting surgical indications.
Purpose of the Study:
- To review current surgical management strategies for neuroendocrine tumors.
- To assess the role of cytoreductive surgery and liver transplantation in NETs.
- To highlight the need for refined selection criteria and neoadjuvant/adjuvant therapies.
Main Methods:
- Review of existing literature on surgical management of NETs.
- Analysis of indications for primary tumor resection, debulking surgery, and liver transplantation.
- Discussion of prognostic factors and outcomes in NET patients undergoing surgery.
Main Results:
- Complete resection offers curative intent but is limited to early-stage NETs.
- Cytoreductive surgery may improve quality of life and survival in selected advanced NET patients.
- Liver transplantation is a viable option for unresectable liver metastases, though recurrence rates necessitate further research.
Conclusions:
- Surgical management of NETs requires careful patient selection, balancing curative intent with palliative goals.
- Resection of primary NETs is feasible even with nonresectable metastases.
- Further development of neoadjuvant and adjuvant strategies is crucial to improve outcomes for NET patients undergoing transplantation or cytoreductive surgery.
