Overview of neuroendocrine liver metastases treatment

Abstract

Although surgical resection is the only way to induce remission (if not cure) in patients with liver metastases (LM) of digestive neuroendocrine tumours (NETS), it cannot be performed in the vast majority of the patients due to the diffusion of hepatic disease. Indeed, despite evolving techniques that may include twostep resection procedures and liver transplantation, the proportion of patients who receive liver resection barely exceeds 15% in specialised centres. Medical and interventional radiological anti-tumour treatments are the mainstay for the management of patients with malignant NETS. The treatment approach is determined by: the tumour biology, location of the primary, natural history and extent of liver involvement. In patients with nonprogressive disease on 2 consecutive CT scans performed at 6-month intervals, with limited (<50% of the liver parenchyma), well-differentiated grade 1 or 2 LM, and