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Liver transplantation as an alternative for the treatment of neuroendocrine liver metastasis:Appraisal of the current evidence

摘要Background:Liver transplantation(LT)for neuroendocrine liver metastases(NELM)is still in debate.Stud-ies comparing LT with liver resection(LR)for NELM are scarce,as patient selection is heterogeneous and experience is limited.The goal of this review was to provide a critical analysis of the evidence on LT versus LR in the treatment of NELM.Data sources:A scoping literature search on LT and LR for NELM was performed with PubMed,including English articles up to March 2023.Results:International guidelines recommend LR for NELM in resectable,well-differentiated tumors in the absence of extrahepatic metastatic disease with superior results of LR compared to systemic or liver-directed therapies.Advanced liver surgery has extended resectability criteria whilst entailing increased perioperative risk and short disease-free survival.In highly selected patients(based on the Milan criteria)with unresectable NELM,oncologic results of LT are promising.Prognostic factors include tumor biology(G1/G2)and burden,waiting time for LT,patient age and extrahepatic spread.Based on low-level evi-dence,LT for low-grade NELM within the Milan criteria resulted in improved disease-free survival and overall survival compared to LR.The benefits of LT were lost in patients beyond the Milan NELM-criteria.Conclusions:With adherence to strict selection criteria especially tumor biology,LT for NELM is becoming a valuable option providing oncologic benefits compared to LR.Recent evidence suggests even stricter selection criteria with regard to tumor biology.

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作者 Philip C.Müller [1] Matthias Pfister [1] Dilmurodjon Eshmuminov [1] Kuno Lehmann [1] 学术成果认领
作者单位 Department of Surgery and Transplantation,University Hospital Zurich,R?mistrasse 100,Zurich CH-8091,Switzerland [1]
栏目名称 REVIEW ARTICLES ON LT AND ALTERNATIVE TREATMENTS IN HB ONCOLOGY
DOI 10.1016/j.hbpd.2023.08.007
发布时间 2024-05-13
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