Long term results of hepatic resection or orthotopic liver transplantation in patients with liver metastases from gastrointestinal neuroendocrine tumors

Pasqual,Enrico  Maria; Bertozzi,Serena; Londero,Ambrogio  P.; Bacchetti,Stefano; Lorenzin,Dario; Pasqualucci,Alberto; Moccheggiani,Federico; Federici,Alen; Vivaverlli,Marco; Risaliti,Andrea

doi:10.3892/ol.2016.5045

Long term results of hepatic resection or orthotopic liver transplantation in patients with liver metastases from gastrointestinal neuroendocrine tumors

Authors:
- Enrico Maria Pasqual
- Serena Bertozzi
- Ambrogio P. Londero
- Stefano Bacchetti
- Dario Lorenzin
- Alberto Pasqualucci
- Federico Moccheggiani
- Alen Federici
- Marco Vivaverlli
- Andrea Risaliti
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Affiliations: Department of Surgery, University of Udine ‑ DISM - DSMB, ‘Santa Maria della Misericordia’ University Hospital, I‑33100 Udine, Italy, Unit of Obstetrics and Gynecology, ‘S. Polo’ Hospital, I‑34074 Monfalcone, Italy, Department of Anaesthesiology, University of Perugia, I-06123 Perugia, Italy, Department of Surgery, Marche Polytechnic University, ‘Ospedali Riuniti Umberto I, G.M. Lancisi, G. Salesi’ University Hospital, I-60123 Ancona, Italy
Published online on: August 25, 2016 https://doi.org/10.3892/ol.2016.5045
Pages: 3563-3570

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Abstract

Hepatic metastases are one of the most important prognostic factors for survival among patients affected by gastrointestinal neuroendocrine tumors (NETs). The present study aims to evaluate the impact of surgery, including hepatic resection or orthotopic liver transplantation (OLT), on the outcome of patients affected by hepatic metastases from NETs, in terms of overall survival (OS). In this multicentric retrospective study, data was collected on 26 patients, who underwent surgery for hepatic metastases from NETs in two Italian University Clinics between January 1990 and December 2012; of which, 22 patients underwent hepatic resective surgery and 4 patients OLT. Hepatic metastases were synchronous in the 53.8% of cases and metachronous in the 46.2% of cases. The median number of resected hepatic metastases was 3. Surgical radicalness (R0) was reached in the 84.6% of cases. In total, 57.7% of patients had a recurrence, 66.7% of which were intra‑ and 33.3% extra‑hepatic. The OS of patients that underwent hepatic resections and OLT was 44.9% [95% confidence interval (CI95), 26.0‑77.7%] and 50% (CI95, 12.5‑100.0%) at 5 years, respectively. Although the data regarding the survival of patients receiving surgery for hepatic metastases from NETs are encouraging, randomized clinical trials are necessary to more adequately evaluate the effect of surgery on survival of this group of patients.

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