Liver transplantation for patients with metastatic endocrine tumors: single-center experience with 15 patients

Frilling, Andrea; Malago, Massimo; Weber, Frank; Paul, Andreas; Nadalin, Silvio; Sotiropoulos, Georgios C; Cicinnati, Vito; Beckebaum, Susanne; Bockisch, Andreas; Mueller-Brand, Jan; Hofmann, Michael; Schmid, Kurt W; Gerken, Guido; Broelsch, Christoph E (2006). Liver transplantation for patients with metastatic endocrine tumors: single-center experience with 15 patients. Liver transplantation, 12(7), pp. 1089-96. Hoboken, N.J.: Wiley 10.1002/lt.20755

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In contrast to other secondary liver malignancy, orthotopic liver transplantation (OLT) is considered as a treatment modality for nonresectable endocrine liver metastases in selected patients. However, only few series have assessed patient selection criteria and long-term results, and no reports have focused on the impact of new technologies in this regard. Between 1992 and 2004, 28 patients with malignant endocrine tumors underwent evaluation for OLT according to our protocol. Data were entered into a prospective database. During pretransplant evaluation, somatostatin receptor scintigraphy detected extrahepatic metastases not diagnosed in standard imaging in 10 patients. Of them, 3 showed aberrant Ki67 labeling results. One patient was excluded from further evaluation due to severe carcinoid heart. Thus far, 15 patients, 10 men and 5 women, aged 37 to 67 years, were subjected to the transplant procedure (11 deceased donor OLT, 3 living donor liver transplantations, and 1 cluster transplantation). Four patients died during the hospital treatment. The median follow-up of the discharged patients was 60.8 months. The actuarial patient survival was 78.3% at 1 year and 67.2% at 5 years. The actuarial 1-, 2-, and 5-year tumor-free survival amounted to 69.4%, 48.3%, and 48.3%, respectively. Two patients underwent surgery for isolated tumor recurrence. In 2 patients, peptide receptor radiotherapy was carried out because of multilocular recurrent disease. In conclusion, liver transplantation is a realistic therapeutic option for highly selected patients with hepatic metastases of endocrine tumors. Our strategy, which implements strict pretransplant selection and aggressive surgical approach, in case of disease recurrence, in addition to systemic radiopeptide treatment, led to an excellent long-term survival cure, however, is unlikely to be achieved.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Clinic of Nuclear Medicine
UniBE Contributor:	Hofmann, Michael
ISSN:	1527-6465
ISBN:	16799958
Publisher:	Wiley
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:49
Last Modified:	05 Dec 2022 14:15
Publisher DOI:	10.1002/lt.20755
PubMed ID:	16799958
Web of Science ID:	000238711700011
URI:	https://boris.unibe.ch/id/eprint/20647 (FactScience: 4322)