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International Journal of Hepatology
Volume 2011, Article ID 452343, 12 pages
http://dx.doi.org/10.4061/2011/452343
Review Article

Multimodal Liver-Directed Management of Neuroendocrine Hepatic Metastases

Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA

Received 21 June 2011; Revised 22 August 2011; Accepted 18 September 2011

Academic Editor: Dermot O'Toole

Copyright © 2011 Mark A. Lewis and Joleen Hubbard. 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

A preponderance of patients with neuroendocrine tumors (NETs) will experience hepatic metastases during the course of their disease. Many diagnoses of NETs are made only after the neoplasms have spread from their primary gastroenteropancreatic sites to the liver. This paper reviews current evidence-based treatments for neuroendocrine hepatic metastases, encompassing surgery, hepatic artery embolization (HAE) and chemoembolization (HACE), radioembolization, hepatic artery infusion (HAI), thermal ablation (radiofrequency, microwave, and cryoablation), alcohol ablation, and liver transplantation as therapeutic modalities. Consideration of a multidisciplinary approach to liver-directed therapy is strongly encouraged to limit morbidity and mortality in this patient population.