Treatment of isolated neuroendocrine liver metastases

Data guiding the appropriate management of patients with hepatic metastases arising from NE primaries, including pancreatic NE tumors, are limited. Long-term survival seems to be enhanced in those patients undergoing resection when it is done with a curative intent and potentially when per-formed as a debulking procedure. Symptoms, includ-ing those arising from hormone production, and pain are effectively treated with locally aggressive treatments including resection, thermal ablation, and tumor embolization. Given the lack of effective chemotherapy, the limited duration of response with hormonal therapy, the often indolent oncologic nature of these diseases, and the increasingly safe profile of these local options, locally aggressive treat-ments remain an important component of care.