Hepatic metastases of gastroenteropancreatic neuroendocrine tumors: Safe hepatic surgery

Liver metastases of neuroendocrine tumors are usually slow-growing, and cyt oreductive hepatectomy can help reduce the effects of endocrinopathies and increase life expectancy and symptom-free survival. However, it has yet to be fully investigated how hepatectomy for metastatic neuroendocrine tumors can be performed safely. Here we report the results of 13 patients with neu roendocrine liver metastases operated on in our institution and those of a French multicentric study that included 131 patients. Preoperative patient selection and appropriate surgical technique, sometimes combined with preop erative portal embolization and local tumor destruction (radiofrequency and cryotherapy), may increase the resectability and the safety of the procedu re. The mortality rate after hepatectomy was 0% (2.3% in the French study); the 3- and 6-year survival rates were 91% and 68%, respectively, in our in stitution (the mean survival time was 66 months in the French multicentric survey). Significant prolonged survival with complete palliation of symptom s can be obtained after liver metastases resection with low mortality.