How to Manage Small Intestine (Jejunal and Ileal) Neuroendocrine Neoplasms Presenting with Liver Metastases?

Author:

Niederle Bruno,Selberherr Andreas,Niederle Martin B.

Abstract

Abstract Purpose of Review Small intestinal neuroendocrine neoplasms (siNENs) are slowly growing tumours with a low malignant potential. However, more than half of the patients present with distant metastases (stage IV) and nearly all with locoregional lymph node (LN) metastases at the time of surgery. The value of locoregional treatment is discussed controversially. Recent Findings In stage I to III disease, locoregional surgery was currently shown to be curative prolonging survival. In stage IV disease, surgery may prolong survival in selected patients with the chance to cure locoregional disease besides radical/debulking liver surgery. It may improve the quality of life and may prevent severe local complications resulting in a state of chronic malnutrition and severe intestinal ischaemia or bowel obstruction. Summary Locoregional tumour resection offers the opportunity to be curative or to focus therapeutically on liver metastasis, facilitating various other therapeutic modalities. Risks and benefits of the surgical intervention need to be balanced individually.

Funder

Medical University of Vienna

Publisher

Springer Science and Business Media LLC

Subject

Oncology

Reference76 articles.

1. • Niederle MB, Hackl M, Kaserer K, Niederle B. Gastroenteropancreatic neuroendocrine tumours: the current incidence and staging based on the WHO and European Neuroendocrine Tumour Society classification: an analysis based on prospectively collected parameters. Endocr Relat Cancer. 2010;17(4):909–18. https://doi.org/10.1677/ERC-10-0152NENs of the digestive tract are more common than previously reported; the majority show benign behaviour, are located in the stomach and are well differentiated. G3 tumours are very rare.

2. Bilimoria KY, Bentrem DJ, Wayne JD, Ko CY, Bennett CL, Talamonti MS. Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg. 2009;249(1):63–71. https://doi.org/10.1097/SLA.0b013e31818e4641.

3. Kloppel G, Rindi G, Anlauf M, Perren A, Komminoth P. Site-specific biology and pathology of gastroenteropancreatic neuroendocrine tumors. Virchows Arch. 2007;451(Suppl 1):S9–27. https://doi.org/10.1007/s00428-007-0461-0.

4. Sun Y, Lohse C, Smyrk T, Hobday T, Kroneman T, Zhang L. The influence of tumor stage on the prognostic value of Ki-67 index and mitotic count in small intestinal neuroendocrine tumors. Am J Surg Pathol. 2018;42(2):247–55. https://doi.org/10.1097/PAS.0000000000000968.

5. •• Norlen O, Stalberg P, Oberg K, Eriksson J, Hedberg J, Hessman O, et al. Long-term results of surgery for small intestinal neuroendocrine tumors at a tertiary referral center. World J Surg. 2012;36(6):1419–31. https://doi.org/10.1007/s00268-011-1296-zLocoregional removal of the primary tumor/mesenteric lymph node metastases was a positive prognostic factor by crude and adjusted analysis and may influence survival.

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