Diagnosis and treatment of Liver metastases from neuroendocrine tumors

被引:26
作者
Lehnert, T
Knaebel, HP
机构
[1] Sektion Chirurgische Onkologie (Leiter: Priv.-Doz. Dr. Th. Lehnert),
[2] Chirurgische Klinik und Poliklinik (Direktor: Prof. Dr. Ch. Herfarth) der Universität Heidelberg,undefined
来源
CHIRURG | 1997年 / 68卷 / 02期
关键词
liver metastases; neuroendocrine tumors; treatment; diagnosis;
D O I
10.1007/s001040050161
中图分类号
R61 [外科手术学];
学科分类号
摘要
Neuroendocrine tumors are rare and slowly progressing malignancies developing predominantly in the gastrointestinal tract. Often symptoms caused by excessive hormone production lead to diagnosis, especially when active metabolites are released from hepatic metastases to reach the systemic circulation before they are inactivated in the liver. Preoperative diagnosis of specific tumors relies on demonstration of the respective hormones in serum or urine rather than on histological diagnosis. Localization of primaries or their metastases can be accomplished by CT-AP, somatostatin receptor scintigraphy, SPECT or PET studies with high sensitivity. At the time of diagnosis more than 60% of tumors have already spread to the liver. Potentially curative resection of liver metastases can achieve 5-year survival rates of more than 60%. Since excess hormone production may be incapacitating and even life-threatening, effective palliation is highly important. Five-year survival following palliative liver resection was calculated to be almost 40%. Palliative liver resection may therefore be considered an alternative to liver transplantation with 5-year survival of 34% in a collected series. If liver resection is not possible, al least temporary palliation of symptoms and retardation of tumor growth can effectively be achieved with somatostatin analogues.
引用
收藏
页码:122 / 131
页数:10
相关论文
共 67 条
[21]  
HALLER D, 1990, P AN M AM SOC CLIN, V9, P102
[22]   TREATMENT OF MALIGNANT METASTATIC MIDGUT CARCINOID-TUMORS WITH RECOMBINANT HUMAN ALPHA-2B INTERFERON WITH OR WITHOUT PRIOR HEPATIC-ARTERY EMBOLIZATION [J].
HANSSEN, LE ;
SCHRUMPF, E ;
KOLBENSTVEDT, AN ;
TAUSJO, J ;
DOLVA, LO .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1989, 24 (07) :787-795
[23]   NEUROENDOCRINE METASTASES OF THE LIVER [J].
IHSE, I ;
PERSSON, B ;
TIBBLIN, S .
WORLD JOURNAL OF SURGERY, 1995, 19 (01) :76-82
[24]   CLINICAL EFFECTS OF OCTREOTIDE COMPARED TO PLACEBO IN PATIENTS WITH GASTROINTESTINAL NEUROENDOCRINE TUMORS - REPORT ON A DOUBLE-BLIND, RANDOMIZED TRIAL [J].
JACOBSEN, MB ;
HANSSEN, LE .
JOURNAL OF INTERNAL MEDICINE, 1995, 237 (03) :269-275
[25]   SURGERY FOR GUT HORMONE-PRODUCING TUMORS [J].
JAFFE, BM .
AMERICAN JOURNAL OF MEDICINE, 1987, 82 (5B) :68-76
[26]   WHOLE ABDOMINAL RADIATION IN THE MANAGEMENT OF METASTATIC GASTROINTESTINAL CARCINOID-TUMOR [J].
KEANE, TJ ;
RIDER, WD ;
HARWOOD, AR ;
THOMAS, GM ;
CUMMINGS, BJ .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1981, 7 (11) :1519-1521
[27]  
KOCKERLING F, 1991, NEUE ENTWICKLUNGEN T, P345
[28]   GASTROINTESTINAL ENDOCRINE TUMORS - INTRODUCTION [J].
KREJS, GJ .
AMERICAN JOURNAL OF MEDICINE, 1987, 82 (5B) :1-3
[29]   SOMATOSTATIN RECEPTOR SCINTIGRAPHY IN CARCINOIDS, GASTRINOMAS AND CUSHINGS SYNDROME [J].
KRENNING, EP ;
KWEKKEBOOM, DJ ;
OEI, HY ;
DEJONG, RJB ;
DOP, FJ ;
DEHERDER, WW ;
REUBI, JC ;
LAMBERTS, SWJ .
DIGESTION, 1994, 55 :54-59
[30]   THE VISUALIZATION OF GASTROENTEROPANCREATIC ENDOCRINE TUMORS [J].
LAMBERTS, SWJ ;
CHAYVIALLE, JA ;
KRENNING, EP .
METABOLISM-CLINICAL AND EXPERIMENTAL, 1992, 41 (09) :111-115