Liver Transplantation for Neuroendocrine Tumors in Europe-Results and Trends in Patient Selection: A 213-Case European Liver Transplant Registry Study.

摘要: OBJECTIVE:: The purpose of this study was to assess outcomes and indications in a large cohort patients who underwent liver transplantation (LT) for metastases (LM) from neuroendocrine tumors (NET) over 27-year period. BACKGROUND:: LT NET remains controversial due the absence clear selection criteria scarcity heterogeneity reported cases. METHODS:: This retrospective multicentric included 213 performed 35 centers 11 European countries between 1982 2009. One hundred seven before 2000 106 after 2000. Mean age at time 46 years. Half presented hormone secretion 55% had hepatomegaly. Before LT, 83% undergone surgical treatment primary tumor and/or LM 76% received chemotherapy. median interval diagnosis 25 months (range, 1-149 months). In addition 24 major resection procedures 30 minor procedures. RESULTS:: Three-month postoperative mortality 10%. At 5 years overall survival (OS) 52% disease-free 30%. LM, OS 73%. Multivariate analysis identified 3 predictors poor outcome, that is, differentiation, Since 2000, 5-year has increased 59% relation with fewer presenting prognostic factors. cases treated since following outcome: hepatomegaly, more than 45 years, any amount concurrent LT. CONCLUSIONS:: is an effective unresectable NET. Patient based on aforementioned can achieve 60% 80%. However, use overly restrictive may deny some could benefit. Optimal timing stable versus progressive disease unclear.