Treatment of neuroendocrine cancer metastatic to the liver: the role of ablative techniques

• Published in: Cardiovascular and interventional radiology Vol. 28; no. 4; pp. 409 - 421
• Main Authors: Atwell, T D, Charboneau, J W, Que, F G, Rubin, J, Lewis, B D, Nagorney, D M, Callstrom, M R, Farrell, M A, Pitot, H C, Hobday, T J
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01-05-2005
• Subjects: ABLATION; Catheter Ablation; Chemoembolization, Therapeutic; Cryosurgery; Ethanol - administration & dosage; Humans; INJECTION; LIVER; Liver Neoplasms - secondary; Liver Neoplasms - therapy; Magnetic Resonance Imaging; Medical treatment; METASTASES; NEOPLASMS; Neuroendocrine Tumors - secondary; Neuroendocrine Tumors - therapy; Ovarian cancer; PATIENTS; Radiography, Interventional; RADIOLOGY AND NUCLEAR MEDICINE; RADIOWAVE RADIATION; SURGERY; SYMPTOMS; Tomography, X-Ray Computed; Tumors
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-004-4082-6

Carcinoid tumors and islet cell neoplasms are neuroendocrine neoplasms with indolent patterns of growth and association with bizarre hormone syndromes. These tumors behave in a relatively protracted and predictable manner, which allows for multiple therapeutic options. Even in the presence of hepatic metastases, the standard of treatment for neuroendocrine malignancy is surgery, either with curative intent or for tumor cytoreduction, i.e., resection of 90% or more of the tumor volume. Image-guided ablation, as either an adjunct to surgery or a primary treatment modality, can be used to treat neuroendocrine cancer metastatic to the liver. Image-guided ablative techniques, including radiofrequency ablation, alcohol injection, and cryoablation, can be used in selected patients to debulk hepatic tumors and improve patient symptoms. Although long-term follow-up data are not available, the surgical literature indicates that significant ablative debulking may improve patient survival. In this review, we discuss metastatic neuroendocrine disease and its treatment options, especially image-guided ablative techniques.