Digestive Disease Interventions 2019; 03(01): 030-037
DOI: 10.1055/s-0038-1675758
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Surgery for Gastroenteropancreatic Neuroendocrine Tumor Liver Metastases

Mark S. Etherington
1   Division of Endocrine and Oncologic Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
,
Robert E. Roses
1   Division of Endocrine and Oncologic Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

06 September 2018

11 September 2018

Publication Date:
17 January 2019 (online)

Abstract

Gastroenteropancreatic-neuroendocrine tumors (GEP-NETs) arise from endocrine cell types along the luminal gastrointestinal tract and pancreas. Stage and grade are dominant predictors of outcome. Optimal management of localized, lower-grade GEP-NETs involves surgical resection, which is associated with excellent long-term survival. While high-grade disease is almost always associated with rapid disseminated progression, metastatic, well-differentiated GEP-NETs can progress slowly and are compatible with prolonged survival. Management of patients with an advanced spectrum of lower grade disease can include a range of systemic and local therapies and requires multidisciplinary collaboration. While controversy persists regarding the optimal scope and sequencing of therapy, surgical management can have a substantial impact alone or in combination with other therapies.

 
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