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Role of liver transplantation in the management of metastatic neuroendocrine tumors
- Source :
- Transplantation Proceedings. 35:1832-1833
- Publication Year :
- 2003
- Publisher :
- Elsevier BV, 2003.
-
Abstract
- Introduction In the majority of patients transplanted for unresectable liver metastases, long-term results are disappointing because of early tumor recurrence. Due to its biologically less aggressive nature, neuroendocrine metastases (NM) may represent a good indication for liver transplantation (LT). Patients and methods Between January 1996 and May 2000, five patients with NM were transplanted. The primary tumors were located in the pancreas (n = 4) and the small bowel (n = 1). In three cases there were symptoms related to hormone production: two carcinoids, and one gastrinoma. The management of primary tumors was sequential in three patients with the tumor being resected before LT (one Whipple procedure and two left pancreatectomies). In two patients the resections of the primary tumors and the LT were simultaneous namely one bowel resection and one left pancreatectomy All patients were treated with chemotherapy. Results Two patients developed recurrent disease succumbing at 15 months (nonfunctioning NE pancreatic head tumor) and 17 months (carcinoid of the pancreatic tail) post-LT. Another patient died at 3 months post-LT due to technical complications. The other two patients are alive and free of recurrence. Conclusion Despite the promising results obtained with LT for NM, our experience indi- cates that patients must be carefully selected. Perhaps the use of more aggressive chemotherapeutic protocols combined with an individualized approach will improve the results.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pancreatic disease
medicine.medical_treatment
Neuroendocrine tumors
Liver transplantation
Gastroenterology
Metastasis
Fatal Outcome
Internal medicine
medicine
Humans
Neoplasm Metastasis
Transplantation
Gastrinoma
business.industry
Bowel resection
Middle Aged
medicine.disease
Liver Transplantation
Surgery
Neuroendocrine Tumors
Treatment Outcome
medicine.anatomical_structure
Female
business
Pancreas
Subjects
Details
- ISSN :
- 00411345
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Transplantation Proceedings
- Accession number :
- edsair.doi.dedup.....459121e3796465f2677f5f0465da29cf
- Full Text :
- https://doi.org/10.1016/s0041-1345(03)00584-0