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Management of advanced neuroendocrine tumors with hepatic metastasis.

Publication ,  Journal Article
Khasraw, M; Gill, A; Harrington, T; Pavlakis, N; Modlin, I
Published in: J Clin Gastroenterol
October 2009

Neuroendocrine tumors (NETs) in general and specifically these gastroenteropancreatic-neuroendocrine tumors often present a considerable diagnostic and therapeutic challenge, especially those that behave in an aggressive fashion. The majority of tumors are diagnosed at a stage that the only curative treatment, radical surgical intervention, is no longer an option and thus long-term therapy with somatostatin analogs is focused on symptom amelioration and in the improvement of quality of life. Although biotherapy is currently the most efficient treatment to achieve palliation, conventional chemotherapy may have some utility in undifferentiated or highly proliferating neuroendocrine carcinomas and pancreatic NETs. Hepatic metastases, depending on size, location, and number may be amenable to surgical resection or radiofrequency ablation. If surgery is not feasible, embolization either alone (bland), in combination with chemotherapeutic agents, or using radioactive microspheres can be used. Peptide receptor targeted radiotherapy using radiolabeled octapeptide analogs (Yttrium or Lutetium-octreotide) may lead to reduction in tumor size, but in most circumstances has a tumor stabilizing effect. A variety of antiangiogenesis and growth factor-targeted agents have been evaluated, but to date, the results have failed to meet our expectations.

Duke Scholars

Published In

J Clin Gastroenterol

DOI

EISSN

1539-2031

Publication Date

October 2009

Volume

43

Issue

9

Start / End Page

838 / 847

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Radiopharmaceuticals
  • Neuroendocrine Tumors
  • Male
  • Liver Neoplasms
  • Immunohistochemistry
  • Humans
  • Hepatectomy
  • Gastroenterology & Hepatology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Khasraw, M., Gill, A., Harrington, T., Pavlakis, N., & Modlin, I. (2009). Management of advanced neuroendocrine tumors with hepatic metastasis. J Clin Gastroenterol, 43(9), 838–847. https://doi.org/10.1097/MCG.0b013e3181b152a1
Khasraw, Mustafa, Anthony Gill, Tim Harrington, Nick Pavlakis, and Irvin Modlin. “Management of advanced neuroendocrine tumors with hepatic metastasis.J Clin Gastroenterol 43, no. 9 (October 2009): 838–47. https://doi.org/10.1097/MCG.0b013e3181b152a1.
Khasraw M, Gill A, Harrington T, Pavlakis N, Modlin I. Management of advanced neuroendocrine tumors with hepatic metastasis. J Clin Gastroenterol. 2009 Oct;43(9):838–47.
Khasraw, Mustafa, et al. “Management of advanced neuroendocrine tumors with hepatic metastasis.J Clin Gastroenterol, vol. 43, no. 9, Oct. 2009, pp. 838–47. Pubmed, doi:10.1097/MCG.0b013e3181b152a1.
Khasraw M, Gill A, Harrington T, Pavlakis N, Modlin I. Management of advanced neuroendocrine tumors with hepatic metastasis. J Clin Gastroenterol. 2009 Oct;43(9):838–847.

Published In

J Clin Gastroenterol

DOI

EISSN

1539-2031

Publication Date

October 2009

Volume

43

Issue

9

Start / End Page

838 / 847

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Radiopharmaceuticals
  • Neuroendocrine Tumors
  • Male
  • Liver Neoplasms
  • Immunohistochemistry
  • Humans
  • Hepatectomy
  • Gastroenterology & Hepatology