神经内分泌肿瘤肝转移的外科干预策略

王俊青; 陈拥军

doi:10.12449/JCH240703

神经内分泌肿瘤肝转移的外科干预策略

DOI: 10.12449/JCH240703

王俊青,
陈拥军^, ,

上海交通大学医学院附属瑞金医院普外科，肝胆外科，上海消化外科研究所，上海 200025

基金项目:

国家自然科学基金 (82372603);

国家自然科学基金 (82172900);

中国临床肿瘤学会希思科—朝阳肿瘤研究基金 (Y-Young2021-0015)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：王俊青负责整理文献，撰写文章；陈拥军负责审阅、修改及定稿。

详细信息

通信作者:
陈拥军， cyj10651@rjh.com.cn （ORCID： 0009-0005-8967-5366）

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出版历程
- 收稿日期: 2024-04-08
- 录用日期: 2024-04-29
- 出版日期: 2024-07-25

Surgical intervention strategies for liver metastasis of neuroendocrine tumors

Junqing WANG,
Yongjun CHEN^{,
,}

Department of General Surgery，Department of Hepatobiliary Surgery，Shanghai Institute of Digestive Surgery，Ruijin Hospital，Shanghai Jiao Tong University School of Medicine，Shanghai 200025，China

Research funding:

National Natural Science Foundation of China (82372603);

National Natural Science Foundation of China (82172900);

CSCO-Chaoyang Oncology Founding for Clinical Research (Y-Young2021-0015)

More Information

Corresponding author: CHEN Yongjun， cyj10651@rjh.com.cn （ORCID： 0009-0005-8967-5366）

摘要

摘要: 神经内分泌肿瘤是一组较罕见的肿瘤性疾病，可发生于身体多种脏器，具有高度肿瘤异质性，常形成以肝脏为最主要受累器官的继发性肿瘤并伴发类癌综合征。肝转移是造成神经内分泌肿瘤患者治疗失败的重要临床事件，通过及时、合理的外科干预有效控制病情发展、争取达到肿瘤无病状态或根治目标，有效延长患者总体生存，是近年来临床医师和研究者聚焦的重要课题。本文综合近年来国内外神经内分泌肿瘤肝转移的外科治疗策略和我国最新诊治指南，并结合笔者实际临床工作经验进行综述和讨论。
- 神经内分泌瘤 /
- 肿瘤转移 /
- 肝 /
- 外科手术
Abstract: Neuroendocrine tumors are a group of rare tumor diseases that can occur in various visceral organs of the human body and exhibit significant tumor heterogeneity， and they often lead to secondary tumors mostly involving the liver and carcinoid syndrome. Liver metastasis is an important cause of treatment failure in patients with neuroendocrine tumor， and timely and reasonable surgical interventions that can effectively control disease progression to achieve the disease-free state or the goal of radical treatment and prolong the overall survival of patients has been a focus of research by clinicians and researchers in recent years. With reference to actual clinical work and working experience， this article reviews and discusses the surgical treatment strategies for liver metastasis of neuroendocrine tumors based on related strategies in China and globally and the latest diagnosis and treatment guidelines in China.
- Neuroendocrine Tumors /
- Neoplasm Metastasis /
- Liver /
- Surgical Procedures， Operative

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参考文献(50)

[1]	Society of Neuroendocrine Neoplasm of China Anti-Cancer Association. China Anti-Cancer Association guideline for diagnosis and treatment of neuroendocrine neoplasm(2022 edition)[J]. China Oncol, 2022, 32( 6): 545- 580. DOI: 10.19401/j.cnki.1007-3639.2022.06.010. 中国抗癌协会神经内分泌肿瘤专业委员会. 中国抗癌协会神经内分泌肿瘤诊治指南(2022年版)[J]. 中国癌症杂志, 2022, 32( 6): 545- 580. DOI: 10.19401/j.cnki.1007-3639.2022.06.010.
[2]	ORONSKY B, MA PC, MORGENSZTERN D, et al. Nothing but NET: A review of neuroendocrine tumors and carcinomas[J]. Neoplasia, 2017, 19( 12): 991- 1002. DOI: 10.1016/j.neo.2017.09.002.
[3]	XU ZH, WANG L, DAI S, et al. Epidemiologic trends of and factors associated with overall survival for patients with gastroenteropancreatic neuroendocrine tumors in the United States[J]. JAMA Netw Open, 2021, 4( 9): e2124750. DOI: 10.1001/jamanetworkopen.2021.24750.
[4]	DASARI A, SHEN C, HALPERIN D, et al. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States[J]. JAMA Oncol, 2017, 3( 10): 1335- 1342. DOI: 10.1001/jamaoncol.2017.0589.
[5]	FRAENKEL M, FAGGIANO A, VALK GD. Epidemiology of neuroendocrine tumors[J]. Front Horm Res, 2015, 44: 1- 23. DOI: 10.1159/000381970.
[6]	FALCONI M, ERIKSSON B, KALTSAS G, et al. ENETS consensus guidelines update for the management of patients with functional pancreatic neuroendocrine tumors and non-functional pancreatic neuroendocrine tumors[J]. Neuroendocrinology, 2016, 103( 2): 153- 171. DOI: 10.1159/000443171.
[7]	ITO T, LEE L, JENSEN RT. Treatment of symptomatic neuroendocrine tumor syndromes: Recent advances and controversies[J]. Expert Opin Pharmacother, 2016, 17( 16): 2191- 2205. DOI: 10.1080/14656566.2016.1236916.
[8]	HOWE JR. Neuroendocrine tumors[J]. Surg Oncol Clin N Am, 2020, 29( 2): xv-xvi. DOI: 10.1016/j.soc.2020.01.001.
[9]	LOU WH. Surgical treatment of liver metastasis in neuroendocrine tumors[C]// Proceedings of the 21st National Clinical Oncology Conference and the 2018 CSCO Academic Annual Conference. 2018: 368- 371. 楼文晖. 神经内分泌肿瘤肝转移的外科治疗[C]// 第二十一届全国临床肿瘤学大会暨2018年CSCO学术年会论文集. 2018: 368- 371.
[10]	MANOJLOVIC-GACIC E, ENGSTRÖM BE, CASAR-BOROTA O. Histopathological classification of non-functioning pituitary neuroendocrine tumors[J]. Pituitary, 2018, 21( 2): 119- 129. DOI: 10.1007/s11102-017-0855-1.
[11]	SCHERÜBL H, RAUE F, FRANK-RAUE K. Neuroendocrine tumors: Classification, clinical presentation and imaging[J]. Radiologe, 2019, 59( 11): 952- 960. DOI: 10.1007/s00117-019-0574-x.
[12]	SCOTT AT, HOWE JR. Evaluation and management of neuroendocrine tumors of the pancreas[J]. Surg Clin N Am, 2019, 99( 4): 793- 814. DOI: 10.1016/j.suc.2019.04.014.
[13]	HOSSAIN J, AL-MOFLEH I, TANDON R, et al. Carcinoid syndrome without liver metastasis[J]. Postgrad Med J, 1989, 65( 766): 597- 599. DOI: 10.1136/pgmj.65.766.597.
[14]	FELDMAN JM, JONES RS. Carcinoid syndrome from gastrointestinal carcinoids without liver metastasis[J]. Ann Surg, 1982, 196( 1): 33- 37. DOI: 10.1097/00000658-198207000-00008.
[15]	HAQ AU, YOOK CR, HIREMATH V, et al. Carcinoid syndrome in the absence of liver metastasis: A case report and review of literature[J]. Med Pediatr Oncol, 1992, 20( 3): 221- 223. DOI: 10.1002/mpo.2950200307.
[16]	SHAH MH, GOLDNER WS, HALFDANARSON TR, et al. NCCN guidelines insights: Neuroendocrine and adrenal tumors, version 2.2018[J]. J Natl Compr Canc Netw, 2018, 16( 6): 693- 702. DOI: 10.6004/jnccn.2018.0056.
[17]	TRAN CG, SHERMAN SK, SCOTT AT, et al. It is time to rethink biomarkers for surveillance of small bowel neuroendocrine tumors[J]. Ann Surg Oncol, 2021, 28( 2): 732- 741. DOI: 10.1245/s10434-020-08784-0.
[18]	MODLIN IM, BODEI LS, KIDD M. Neuroendocrine tumor biomarkers: From monoanalytes to transcripts and algorithms[J]. Best Pract Res Clin Endocrinol Metab, 2016, 30( 1): 59- 77. DOI: 10.1016/j.beem.2016.01.002.
[19]	DROMAIN C, de BAERE T, LUMBROSO J, et al. Detection of liver metastases from endocrine tumors: A prospective comparison of somatostatin receptor scintigraphy, computed tomography, and magnetic resonance imaging[J]. J Clin Oncol, 2005, 23( 1): 70- 78. DOI: 10.1200/JCO.2005.01.013.
[20]	CATON MT Jr, SHINAGARE AB, LEE B, et al. Optimization of timing of hepatocellular phase imaging after gadoxetate disodium injection for evaluation of patients with neuroendocrine tumor[J]. Abdom Radiol(NY), 2020, 45( 8): 2358- 2369. DOI: 10.1007/s00261-020-02515-5.
[21]	DUAN HY, IAGARU A. Neuroendocrine tumor diagnosis: PET/MR imaging[J]. PET Clin, 2023, 18( 2): 259- 266. DOI: 10.1016/j.cpet.2022.11.008.
[22]	BRIGANTI V, CUCCURULLO V, DI STASIO GD, et al. Gamma emitters in pancreatic endocrine tumors imaging in the PET era: Is there a clinical space for 99mTc-peptides?[J]. Curr Radiopharm, 2019, 12( 2): 156- 170. DOI: 10.2174/1874471012666190301122524.
[23]	SEKAR A, VAIPHEI K. Clinical and pathological profile of gastric neuroendocrine tumors[J]. Indian J Pathol Microbiol, 2022, 65( 3): 551- 557. DOI: 10.4103/ijpm.ijpm_824_21.
[24]	MAXWELL JE, SHERMAN SK, STASHEK KM, et al. A practical method to determine the site of unknown primary in metastatic neuroendocrine tumors[J]. Surgery, 2014, 156( 6): 1359- 1365. DOI: 10.1016/j.surg.2014.08.008.
[25]	SHERMAN SK, MAXWELL JE, CARR JC, et al. Gene expression accurately distinguishes liver metastases of small bowel and pancreas neuroendocrine tumors[J]. Clin Exp Metastasis, 2014, 31( 8): 935- 944. DOI: 10.1007/s10585-014-9681-2.
[26]	YAO JC, PAVEL M, LOMBARD-BOHAS C, et al. Everolimus for the treatment of advanced pancreatic neuroendocrine tumors: Overall survival and circulating biomarkers from the randomized, phase III RADIANT-3 study[J]. J Clin Oncol, 2016, 34( 32): 3906- 3913. DOI: 10.1200/JCO.2016.68.0702.
[27]	RINKE A, WITTENBERG M, SCHADE-BRITTINGER C, et al. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors(PROMID): Results of long-term survival[J]. Neuroendocrinology, 2017, 104( 1): 26- 32. DOI: 10.1159/000443612.
[28]	SINGH S, CHAN DL, MOODY L, et al. Recurrence in resected gastroenteropancreatic neuroendocrine tumors[J]. JAMA Oncol, 2018, 4( 4): 583- 585. DOI: 10.1001/jamaoncol.2018.0024.
[29]	MAYO SC, de JONG MC, PULITANO C, et al. Surgical management of hepatic neuroendocrine tumor metastasis: Results from an international multi-institutional analysis[J]. Ann Surg Oncol, 2010, 17( 12): 3129- 3136. DOI: 10.1245/s10434-010-1154-5.
[30]	SARMIENTO JM, HEYWOOD G, RUBIN J, et al. Surgical treatment of neuroendocrine metastases to the liver: A plea for resection to increase survival[J]. J Am Coll Surg, 2003, 197( 1): 29- 37. DOI: 10.1016/S1072-7515(03)00230-8.
[31]	ELIAS D, LEFEVRE JH, DUVILLARD P, et al. Hepatic metastases from neuroendocrine tumors with a“thin slice” pathological examination: they are many more than you think[J]. Ann Surg, 2010, 251( 2): 307- 310. DOI: 10.1097/SLA.0b013e3181bdf8cf.
[32]	LIANG HJ. Consensus on diagnosis and treatment of liver metastasis in neuroendocrine tumors[C]// Proceedings of the 16th National Conference on Clinical Oncology and the 2013 CSCO Academic Annual Conference. 2013: 552- 555. 梁后杰. 神经内分泌肿瘤肝转移诊治共识[C]// 第十六届全国临床肿瘤学大会暨2013年CSCO学术年会论文集. 2013: 552- 555.
[33]	HOWE JR, CARDONA K, FRAKER DL, et al. The surgical management of small bowel neuroendocrine tumors: Consensus guidelines of the North American Neuroendocrine Tumor Society[J]. Pancreas, 2017, 46( 6): 715- 731. DOI: 10.1097/MPA.0000000000000846.
[34]	GLAZER ES, TSENG JF, AL-REFAIE W, et al. Long-term survival after surgical management of neuroendocrine hepatic metastases[J]. HPB(Oxford), 2010, 12( 6): 427- 433. DOI: 10.1111/j.1477-2574.2010.00198.x.
[35]	FOSTER JH, LUNDY J. Liver metastases[J]. Curr Probl Surg, 1981, 18( 3): 157- 202. DOI: 10.1016/s0011-3840(81)80009-3.
[36]	MCENTEE GP, NAGORNEY DM, KVOLS LK, et al. Cytoreductive hepatic surgery for neuroendocrine tumors[J]. Surgery, 1990, 108( 6): 1091- 1096.
[37]	QUE FG, NAGORNEY DM, BATTS KP, et al. Hepatic resection for metastatic neuroendocrine carcinomas[J]. Am J Surg, 1995, 169( 1): 36- 42. DOI: 10.1016/s0002-9610(99)80107-x.
[38]	GRAFF-BAKER AN, SAUER DA, POMMIER SJ, et al. Expanded criteria for carcinoid liver debulking: Maintaining survival and increasing the number of eligible patients[J]. Surgery, 2014, 156( 6): 1369- 1376. DOI: 10.1016/j.surg.2014.08.009.
[39]	MAXWELL JE, SHERMAN SK, O’DORISIO TM, et al. Liver-directed surgery of neuroendocrine metastases: What is the optimal strategy?[J]. Surgery, 2016, 159( 1): 320- 333. DOI: 10.1016/j.surg.2015.05.040.
[40]	HOWE JR, MERCHANT NB, CONRAD C, et al. The North American Neuroendocrine Tumor Society Consensus Paper on the surgical management of pancreatic neuroendocrine tumors[J]. Pancreas, 2020, 49( 1): 1- 33. DOI: 10.1097/MPA.0000000000001454.
[41]	KINNEY MA, WARNER ME, NAGORNEY DM, et al. Perianaesthetic risks and outcomes of abdominal surgery for metastatic carcinoid tumours[J]. Br J Anaesth, 2001, 87( 3): 447- 452. DOI: 10.1093/bja/87.3.447.
[42]	CONDRON ME, JAMESON NE, LIMBACH KE, et al. A prospective study of the pathophysiology of carcinoid crisis[J]. Surgery, 2019, 165( 1): 158- 165. DOI: 10.1016/j.surg.2018.04.093.
[43]	TRAN CG, SHERMAN SK, HOWE JR. Small bowel neuroendocrine tumors[J]. Curr Probl Surg, 2020, 57( 12): 100823. DOI: 10.1016/j.cpsurg.2020.100823.
[44]	ELIAS D, BATON O, SIDERIS L, et al. Hepatectomy plus intraoperative radiofrequency ablation and chemotherapy to treat technically unresectable multiple colorectal liver metastases[J]. J Surg Oncol, 2005, 90( 1): 36- 42. DOI: 10.1002/jso.20237.
[45]	AKYILDIZ HY, MITCHELL J, MILAS M, et al. Laparoscopic radiofrequency thermal ablation of neuroendocrine hepatic metastases: Long-term follow-up[J]. Surgery, 2010, 148( 6): 1288- 1293. DOI: 10.1016/j.surg.2010.09.014.
[46]	VOGL TJ, NAGUIB NNN, ZANGOS S, et al. Liver metastases of neuroendocrine carcinomas: Interventional treatment via transarterial embolization, chemoembolization and thermal ablation[J]. Eur J Radiol, 2009, 72( 3): 517- 528. DOI: 10.1016/j.ejrad.2008.08.008.
[47]	MAYO SC, de JONG MC, BLOOMSTON M, et al. Surgery versus intra-arterial therapy for neuroendocrine liver metastasis: A multicenter international analysis[J]. Ann Surg Oncol, 2011, 18( 13): 3657- 3665. DOI: 10.1245/s10434-011-1832-y.
[48]	CAPLIN ME, PAVEL M, ĆWIKŁA JB, et al. Lanreotide in metastatic enteropancreatic neuroendocrine tumors[J]. N Engl J Med, 2014, 371( 3): 224- 233. DOI: 10.1056/NEJMoa1316158.
[49]	YAO JC, FAZIO N, SINGH S, et al. Everolimus for the treatment of advanced, non-functional neuroendocrine tumours of the lung or gastrointestinal tract(RADIANT-4): A randomised, placebo-controlled, phase 3 study[J]. Lancet, 2016, 387( 10022): 968- 977. DOI: 10.1016/S0140-6736(15)00817-X.
[50]	BASU S, PARGHANE RV, KAMALDEEP, et al. Peptide receptor radionuclide therapy of neuroendocrine tumors[J]. Semin Nucl Med, 2020, 50( 5): 447- 464. DOI: 10.1053/j.semnuclmed.2020.05.004.