Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence

Background/Objectives: Neuroendocrine neoplasms (NEN) are heterogeneous entities. Despite considerable advancement in the field, almost 50% of patients have metastatic disease, when liver transplantation (LT) is one of the possible treatments offering a cure in well-selected patients. Methods: The p...

Full description

Saved in:
Bibliographic Details
Main Authors: Quirino Lai, Alessandro Coppola, Anna Mrzljak, Maja Cigrovski Berkovic
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/12/11/2419
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850267359370018816
author Quirino Lai
Alessandro Coppola
Anna Mrzljak
Maja Cigrovski Berkovic
author_facet Quirino Lai
Alessandro Coppola
Anna Mrzljak
Maja Cigrovski Berkovic
author_sort Quirino Lai
collection DOAJ
description Background/Objectives: Neuroendocrine neoplasms (NEN) are heterogeneous entities. Despite considerable advancement in the field, almost 50% of patients have metastatic disease, when liver transplantation (LT) is one of the possible treatments offering a cure in well-selected patients. Methods: The present study aims to systematically review all the literature from 2000 onwards on using LT for patients with NEN-LM, with particular attention to the risk factors of death and recurrence. Results: LT offers 5-year OS ranging from 52 to 74% and 5-year TFS rates ranging from 39 to 62%, with even better results published from 2009 onwards. The main risk factors for patient deaths are related to unfavorable primary tumor pathology, higher liver involvement, and simultaneous LT and primary resection. Similarly, recurrence is higher related to poor tumor grade and differentiation, and in the case of an older recipient age. Conclusions: Applying uniform criteria and a more in-depth understanding of the relevant prognostic factors contribute to a better selection of candidates for curative LT due to NEN metastases. LT for unresectable or liver-restricted NENs has a relevant place in the treatment algorithm and has achieved excellent results in recent decades, but more international efforts are needed to further improve outcomes.
format Article
id doaj-art-a2ab7dc2fbb047cfa0187ce9a98bb4a3
institution OA Journals
issn 2227-9059
language English
publishDate 2024-10-01
publisher MDPI AG
record_format Article
series Biomedicines
spelling doaj-art-a2ab7dc2fbb047cfa0187ce9a98bb4a32025-08-20T01:53:49ZengMDPI AGBiomedicines2227-90592024-10-011211241910.3390/biomedicines12112419Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and RecurrenceQuirino Lai0Alessandro Coppola1Anna Mrzljak2Maja Cigrovski Berkovic3General Surgery and Organ Transplantation Unit, Department of General and Specialty Surgery, Sapienza University of Rome, 00161 Rome, ItalyDepartment of General Surgery, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Gastroenterology and Hepatology, Liver Transplant Center, University Hospital Centre Zagreb, 10000 Zagreb, CroatiaUniversity of Zagreb, Faculty of Kinesiology, 10000 Zagreb, CroatiaBackground/Objectives: Neuroendocrine neoplasms (NEN) are heterogeneous entities. Despite considerable advancement in the field, almost 50% of patients have metastatic disease, when liver transplantation (LT) is one of the possible treatments offering a cure in well-selected patients. Methods: The present study aims to systematically review all the literature from 2000 onwards on using LT for patients with NEN-LM, with particular attention to the risk factors of death and recurrence. Results: LT offers 5-year OS ranging from 52 to 74% and 5-year TFS rates ranging from 39 to 62%, with even better results published from 2009 onwards. The main risk factors for patient deaths are related to unfavorable primary tumor pathology, higher liver involvement, and simultaneous LT and primary resection. Similarly, recurrence is higher related to poor tumor grade and differentiation, and in the case of an older recipient age. Conclusions: Applying uniform criteria and a more in-depth understanding of the relevant prognostic factors contribute to a better selection of candidates for curative LT due to NEN metastases. LT for unresectable or liver-restricted NENs has a relevant place in the treatment algorithm and has achieved excellent results in recent decades, but more international efforts are needed to further improve outcomes.https://www.mdpi.com/2227-9059/12/11/2419neuroendocrine neoplasmsgastrointestinal tractpancreatic neuroendocrine neoplasmsgradedifferentiationliver metastases
spellingShingle Quirino Lai
Alessandro Coppola
Anna Mrzljak
Maja Cigrovski Berkovic
Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence
Biomedicines
neuroendocrine neoplasms
gastrointestinal tract
pancreatic neuroendocrine neoplasms
grade
differentiation
liver metastases
title Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence
title_full Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence
title_fullStr Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence
title_full_unstemmed Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence
title_short Liver Transplantation for the Cure of Neuroendocrine Liver Metastasis: A Systematic Review with Particular Attention to the Risk Factors of Death and Recurrence
title_sort liver transplantation for the cure of neuroendocrine liver metastasis a systematic review with particular attention to the risk factors of death and recurrence
topic neuroendocrine neoplasms
gastrointestinal tract
pancreatic neuroendocrine neoplasms
grade
differentiation
liver metastases
url https://www.mdpi.com/2227-9059/12/11/2419
work_keys_str_mv AT quirinolai livertransplantationforthecureofneuroendocrinelivermetastasisasystematicreviewwithparticularattentiontotheriskfactorsofdeathandrecurrence
AT alessandrocoppola livertransplantationforthecureofneuroendocrinelivermetastasisasystematicreviewwithparticularattentiontotheriskfactorsofdeathandrecurrence
AT annamrzljak livertransplantationforthecureofneuroendocrinelivermetastasisasystematicreviewwithparticularattentiontotheriskfactorsofdeathandrecurrence
AT majacigrovskiberkovic livertransplantationforthecureofneuroendocrinelivermetastasisasystematicreviewwithparticularattentiontotheriskfactorsofdeathandrecurrence