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01-05-2008

Surgery and Radiofrequency Ablation for Treatment of Liver Metastases from Midgut and Foregut Carcinoids and Endocrine Pancreatic Tumors

Authors: John Eriksson, Peter Stålberg, Anders Nilsson, Johan Krause, Christina Lundberg, Britt Skogseid, Dan Granberg, Barbro Eriksson, Göran Åkerström, Per Hellman

Published in: World Journal of Surgery | Issue 5/2008

Abstract

Background

Many neuroendocrine tumors (NETs) have a tendency to metastasize to the liver. In case of limited number of metastases, liver surgery or radiofrequency ablation (RFA) may result in apparently total clearance of metastases. However, it is not clear whether such therapy will provide symptom reduction or increased survival.

Methods

Seventy-three patients with foregut (n = 6) or midgut carcinoids (n = 37) or endocrine pancreatic tumors (n = 28), and two patients with NETs without discernable origin were studied. Symptoms were evaluated using a Symptom Severity Score. Liver surgery was performed in 42 operations and RFA on 205 lesions.

Results

Apparently total clearance of liver metastases was attained in 1 of 6 patients with foregut carcinoids, 15 of 37 with midgut carcinoids, and 13 of 28 with EPT. Symptom improvement was noted in 12 of 17 (70.6%) patients with carcinoid syndrome, and 75% also reduced their 5-HIAA and P-CgA by at least 50%. Patients with nonfunctioning EPT generally had no improvement of symptoms after surgical/RFA liver treatment, but eight patients had functioning EPT, and four of these reduced their biochemical markers by at least 50%. NETs with higher Ki67 index tended to recur more often. Complications occurred in 9 of 45 open surgery procedures, and in 8 of 203 RFA procedures.

Conclusions

Treatment of liver metastases is successful in midgut carcinoid patients with limited liver metastases. Patients with foregut carcinoid and EPTs recur more often, possibly related to higher Ki67 index, and treatment of liver lesions less often reduces symptoms. Liver resections and RFA may be safely performed, and RFA is associated with few complications.

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Title: Surgery and Radiofrequency Ablation for Treatment of Liver Metastases from Midgut and Foregut Carcinoids and Endocrine Pancreatic Tumors
Authors: John Eriksson
Peter Stålberg
Anders Nilsson
Johan Krause
Christina Lundberg
Britt Skogseid
Dan Granberg
Barbro Eriksson
Göran Åkerström
Per Hellman
Publication date: 01-05-2008
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 5/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-008-9510-3

ACC 2024 Congress

Springer Medicine

Surgery and Radiofrequency Ablation for Treatment of Liver Metastases from Midgut and Foregut Carcinoids and Endocrine Pancreatic Tumors

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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