Treatment of Neuroendocrine Tumor Liver Metastases

In the care of patients with hepatic neuroendocrine metastases, medical oncologists should work in multidisciplinary fashion with surgeons, interventional radiologists, and radiation oncologists to assess the potential utility of liver-directed and systemic therapies. This paper addresses the various roles and evidence basis for cytoreductive surgery, thermal ablation (radiofrequency, microwave, and cryoablation), and embolization (bland embolization (HAE), chemoembolization (HACE), and radioembolization) as liver-directed therapies. Somatostatin analogues, cytotoxic chemotherapy, and the newer agents everolimus and suntinib are discussed as a means for controlling intra- and extrahepatic disease, along with peptide receptor radiotherapy (PRRT). Finally, the experience with orthotopic liver transplant for neuroendocrine tumors is described.

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Small Bowel and Colorectal Carcinoids

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0038-1642054 ◽

2018 ◽

Vol 31 (05) ◽

pp. 301-308 ◽

Cited By ~ 3

Author(s):

Raphael Byrne ◽

Rodney Pommier

Keyword(s):

Small Bowel ◽

Neuroendocrine Tumors ◽

Cytoreductive Surgery ◽

Mammalian Target Of Rapamycin ◽

Arterial Embolization ◽

Angiogenesis Inhibitors ◽

Somatostatin Analogues ◽

Interferon Α ◽

Peptide Receptor ◽

Hepatic Arterial Embolization

AbstractNeuroendocrine tumors, or carcinoid tumors, of both the midgut and hindgut are quite rare, but their incidence is increasing. Surgery is the treatment of choice in patients who can tolerate an operation and have operable disease. Options for the treatment of metastatic disease include cytoreductive surgery, somatostatin analogues, interferon α, local liver therapies (hepatic arterial embolization, ablation), chemotherapy, Peptide-Receptor Radionucleotide Radiotherapy, angiogenesis inhibitors, and mammalian target of rapamycin inhibitors.

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Prognosis of the combination therapy results in patients with synchronous metastases of colorectal cancer

Science and Innovations in Medicine ◽

10.35693/2500-1388-2019-4-3-60-64 ◽

2019 ◽

Vol 4 (3) ◽

pp. 60-64

Author(s):

S. V Kozlov ◽

O. I Kaganov ◽

A. A Moryatov ◽

A. M Kozlov ◽

A. P Borisov

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Cytoreductive Surgery ◽

Thermal Ablation ◽

Combined Treatment ◽

Stage Iv ◽

Radiofrequency Thermal Ablation ◽

Mutational Status ◽

Synchronous Metastases ◽

Metastatic Liver

Objectives - to optimize the indications for radiofrequency thermal ablation in patients with synchronous multiple metastases of colorectal cancer to the liver on the basis of prognostic treatment results. Material and methods. The study group included 78 patients with colorectal cancer with synchronous multiple bilobar liver metastases, who have underwent combined treatment in the period of 2007- 2015, such as cytoreductive surgery removing the primary intestinal tumor in combination with RFA of metastases in the liver, followed by chemotherapy. Results. A computer program for preoperative risk assessment of disease progression was developed and introduced in clinical practice. It is based on the results of the analysis of the factors, predicting the risk of relapse during the first year after cytoreductive surgery with RFA of synchronous multiple CRC liver metastases. Conclusion. The index of metastatic liver damage (the product of the sum of the diameters of metastatic liver lesions by their number), the mutational status of the KRAS gene, CEA values are significant factors in predicting the progression of the disease, which can optimize indications for radiofrequency thermal ablation in the treatment of patients with stage IV CRC with synchronous metastases to the liver.

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Abstract No. 19 Optimal timing of cytotoxic chemotherapy when combined with thermal ablation of liver metastases

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2021.03.433 ◽

2021 ◽

Vol 32 (5) ◽

pp. S9-S10

Author(s):

A. Maxwell ◽

C. Sofocleous ◽

S. Solomon ◽

N. Kemeny ◽

J. Camacho ◽

...

Keyword(s):

Liver Metastases ◽

Thermal Ablation ◽

Cytotoxic Chemotherapy ◽

Optimal Timing

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Initial results using radiofrequency interstitial thermal ablation (RITA) for the management of liver metastases

Zeitschrift für Gastroenterologie ◽

10.1055/s-2004-827004 ◽

2004 ◽

Vol 42 (05) ◽

Author(s):

G OBrien ◽

L Romics ◽

A El-Sayed ◽

A Fuad ◽

H Redmond

Keyword(s):

Liver Metastases ◽

Thermal Ablation ◽

Radiofrequency Interstitial Thermal Ablation ◽

Initial Results

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Discrepancies between medical oncologists and surgeons in assessment of resectability and indication for chemotherapy in patients with colorectal liver metastases

British Journal of Surgery ◽

10.1002/bjs.9436 ◽

2014 ◽

Vol 101 (5) ◽

pp. 550-557 ◽

Cited By ~ 23

Author(s):

K. Homayounfar ◽

A. Bleckmann ◽

H.-J. Helms ◽

F. Lordick ◽

J. Rüschoff ◽

...

Keyword(s):

Liver Metastases ◽

Colorectal Liver Metastases ◽

Medical Oncologists

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Integrating Systemic Therapies into the Multimodality Treatment of Resectable Colorectal Liver Metastases

Gastroenterology Research and Practice ◽

10.1155/2018/4326082 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Omar Abdel-Rahman ◽

Winson Y. Cheung

Keyword(s):

Liver Metastases ◽

Management Strategy ◽

Multimodality Treatment ◽

Treatment Modalities ◽

Considerable Proportion ◽

Optimal Management ◽

Related Factors ◽

Multiple Treatment ◽

Current Review ◽

Systemic Therapies

Colorectal carcinoma (CRC) is one of the most common cancers worldwide. A considerable proportion of CRC patients may present with metastatic disease either at upfront presentation (synchronous with the primary) or following diagnosis and treatment of the primary tumor (metachronous). Management of CRC liver metastases is a challenging endeavor which frequently necessitates proper assessment of patient- and disease-related factors. There is an opportunity within the management of CRC liver metastases to incorporate multiple treatment modalities (including surgery, other locoregional treatments, and systemic therapy). The current review aims to provide an updated overview on the optimal management strategy for CRC patients with liver metastases with a specific focus on the integration of systemic and/or locoregional treatments among patients with resectable or potentially resectable disease.

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