Patient Selection and Surgical Approach to Neuroendocrine Tumor Liver Metastases

Abstract

Despite the relatively indolent course of neuroendocrine tumor (NETs), the incidence of NET liver metastases (NETLMs) is relatively common in patients with NETs. The surgical approach to NETLMs is based upon proper patient selection, the distribution of lesions, percent of liver replacement, and the ability to achieve significant cytoreduction. Goals of therapy are symptom improvement, as well as increased progression-free and overall survival. While other modalities such as systemic therapy, embolic approaches, and peptide receptor radionuclide therapy (PRRT) may slow progression and occasionally show objective responses, surgical debulking leads to the most immediate and potentially substantive reduction in tumor volume.