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International Journal of Hepatology
Volume 2011 (2011), Article ID 154541, 11 pages
http://dx.doi.org/10.4061/2011/154541
Review Article

Treatment of Liver Metastases in Patients with Neuroendocrine Tumors: A Comprehensive Review

1Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Suite No. 404D, Houston, TX 77030, USA
2Division of Abdominal Transplantation, The Liver Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 1709 Dryden Street, Suite No. 1500, Houston, TX 77030, USA

Received 15 July 2011; Accepted 10 August 2011

Academic Editor: Dan Granberg

Copyright © 2011 Theresa R. Harring et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients diagnosed with Neuroendocrine Tumors (NET) often are also diagnosed with Neuroendocrine Liver Metastases (NLM) during the course of their disease. NLM can cause significant morbidity and mortality, oftentimes much more than compared to patients with NET. Treatment options have been limited in the past, focusing on surgical resections, for which only a minority of patients are candidates. However, developments of new treatment modalities have progressed rapidly and patients with NLM now have significantly more options, including surgical-directed therapies; liver-directed therapies; and nonsurgical, non-liver-directed therapies. This review provides information about the roles of hepatic resection, orthotopic liver resection, radiofrequency ablation, hepatic artery embolization and hepatic artery chemoembolization, hepatic artery radioembolization and selective internal radiation therapy, peptide receptor radionuclide therapy, systemic chemotherapy, biotherapies including somatostatin analogs and interferon-α, vascular endothelial growth factor and mTOR targets, and microRNA-regulated pathways. Given these new options, the clinician can tailor therapy specific to the patient diagnosed with NLM, thereby giving the patient the best possible chance of prolonged survival.