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Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence

  • 0General Surgery and Organ Transplantation Unit, Department of General and Specialty Surgery, Sapienza University of Rome, 00161 Rome, Italy.
Biomedicines +

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November 27, 2024

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November 27, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Liver transplantation (LT) offers a potential cure for select patients with neuroendocrine neoplasms with liver metastases (NEN-LM). Careful patient selection based on prognostic factors is crucial for improving survival and reducing recurrence after LT.

Area Of Science

  • Hepatobiliary Surgery
  • Transplant Surgery
  • Surgical Oncology

Background

  • Neuroendocrine neoplasms (NEN) are diverse tumors, with nearly 50% of patients presenting with metastatic disease.
  • Liver transplantation (LT) is a curative option for carefully selected patients with NEN metastases to the liver (NEN-LM).

Purpose Of The Study

  • To systematically review literature from 2000 onwards on LT for NEN-LM.
  • To identify risk factors associated with mortality and recurrence following LT for NEN-LM.

Main Methods

  • Systematic literature review of studies published from 2000 to present.
  • Analysis of risk factors for death and recurrence in patients undergoing LT for NEN-LM.

Main Results

  • LT demonstrates 5-year overall survival (OS) rates of 52-74% and 5-year treatment-free survival (TFS) rates of 39-62%, with improved outcomes noted from 2009 onwards.
  • Key risk factors for mortality include unfavorable primary tumor pathology, extensive liver involvement, and combined LT with primary tumor resection.
  • Recurrence is associated with poor tumor grade/differentiation and older recipient age.

Conclusions

  • Standardized criteria and improved understanding of prognostic factors enhance candidate selection for curative LT in NEN metastases.
  • LT is a valuable treatment for unresectable or liver-confined NENs, yielding excellent results.
  • Further international collaboration is necessary to optimize outcomes for LT in NEN-LM.

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