Role of surgery for liver metastases from neuroendocrine tumors (both pancreatic and nonpancreatic)
Surgical resection is the recommended treatment for patients with liver metastases from intestinal NETs and/or PNETs. These patients experience symptomatic improvement and have prolonged survival (58%–70% versus 25%–30% 5-year survival rates) compared with similar patients who do not undergo hepatic resection. Patients with unresectable liver metastases, those with poor baseline liver function, or those with tumor recurrence (after prior hepatic resections) may benefit from other therapies, such as radiofrequency thermal ablation and/or transarterial chemoembolization. Nonresectable NET liver metastasis resistant to medical treatment and confined to the liver is an accepted indication for liver transplantation; however, most patients eventually develop recurrence.