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Therapeutic alternatives in metastatic neuroendocrine tumors
1Department of Surgery, Ohio State University Medical Center, Columbus, Ohio, USA.
Abstract:
In the treatment of neuroendocrine tumors that cannot be resected for cure two goals must be addressed: (1) the control of symptoms related to hormonal hypersecretion and (2) the prolongation of survival by destruction of tumor of the limitation of its growth. Clinical approaches, medical and surgical, have been developed in recent years to meet these goals. Surgical options in the face of metastatic disease include resection of hepatic metastases, cryoablation, and liver transplantation. Medical therapy includes treatment of symptomatic hypersecretory states and systemic chemotherapeutic and immunomodulatory regimes. Hepatic artery chemoembolization has also been used successfully in the treatment of hepatic metastases of neuroendocrine tumors.
Insights
Treatment for unresectable neuroendocrine tumors focuses on managing hormonal symptoms and extending survival. Current medical and surgical strategies aim to control tumor growth and improve patient outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Oncology
Background:
- Neuroendocrine tumors (NETs) present challenges in treatment when unresectable.
- Effective management requires addressing both symptom control and tumor burden.
Purpose of the Study:
- To outline current clinical approaches for managing unresectable neuroendocrine tumors.
- To discuss strategies for symptom control and survival prolongation.
Main Methods:
- Review of surgical interventions including resection of hepatic metastases, cryoablation, and liver transplantation.
- Overview of medical therapies such as hormonal symptom management, chemotherapy, and immunotherapy.
- Inclusion of locoregional therapies like hepatic artery chemoembolization.
Main Results:
- Surgical options provide means to manage metastatic disease, particularly in the liver.
- Medical therapies target hormonal hypersecretion and systemic tumor control.
- Hepatic artery chemoembolization demonstrates success in treating liver metastases.
Conclusions:
- A multimodal approach combining surgical, medical, and locoregional therapies is crucial for unresectable NETs.
- These strategies aim to improve quality of life by controlling symptoms and prolong survival.