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International Journal of Hepatology
Volume 2012, Article ID 973946, 12 pages
http://dx.doi.org/10.1155/2012/973946
Review Article

Treatment of Neuroendocrine Tumor Liver Metastases

Division of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA

Received 19 July 2012; Accepted 27 October 2012

Academic Editor: Matthias Bahr

Copyright © 2012 Mark A. Lewis and Timothy J. Hobday. 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

In the care of patients with hepatic neuroendocrine metastases, medical oncologists should work in multidisciplinary fashion with surgeons, interventional radiologists, and radiation oncologists to assess the potential utility of liver-directed and systemic therapies. This paper addresses the various roles and evidence basis for cytoreductive surgery, thermal ablation (radiofrequency, microwave, and cryoablation), and embolization (bland embolization (HAE), chemoembolization (HACE), and radioembolization) as liver-directed therapies. Somatostatin analogues, cytotoxic chemotherapy, and the newer agents everolimus and suntinib are discussed as a means for controlling intra- and extrahepatic disease, along with peptide receptor radiotherapy (PRRT). Finally, the experience with orthotopic liver transplant for neuroendocrine tumors is described.