| Título: | Liver transplantation for symptomatic liver metastases of neuroendocrine tumours |
| Autores: |
Chan, G.; Hôpital Maisonneuve-Rosemont
Université de Montréal Kocha, W. Reid, R. Taqi, A. Wall, W. Quan, D. |
| Fecha: | 2012-08-02 |
| Publicador: | Multimed Inc. |
| Fuente: |
Ver documento |
| Tipo: |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| Tema: | Liver transplantation; neuroendocrine tumour; liver metastases |
| Descripción: | Numerous reports have demonstrated that liver transplantation for neuroendocrine tumour metastasis is feasible. However, perioperative risks and long-term recurrences remain significant concerns. When liver transplantation is combined with extensive intestinal or pancreatic resection, the risk is particularly high.We report our institutional experience of liver transplantations performed for liver metastases secondary to neuroendocrine tumours, and in combination with a review of the literature, we propose a set of selection criteria. The key points include unresectable hepatic metastases of neuroendocrine origin, absence of extrahepatic metastases, symptomatic disease that is refractory to medical therapy, a Ki-67 level less than 2%, previous resection of the primary disease, and previous therapy for metastatic neuroendocrine tumour.In our experience, the patient in the first case had, post-transplantation, rapid disease progression because of an unidentified primary, and patient in the second case had primary non-function of the liver graft, requiring urgent re-transplantation. More recently, two liver transplantations were successfully performed. The indications were, in the first case, refractory hormonal secretion and, in the other, secondary biliary cirrhosis attributable to hepatic artery therapy with tumour in situ. Subclinical and stable recurrent disease has been detected by scintigraphy in the mesentery and lumbar spine in the former patient. A mesenteric recurrence developed in the latter patient 2 years post transplantation and was subsequently completely resected. At 4 and 5 years post transplantation, both patients are symptom-free. Recurrence after transplantation remains a significant concern, even with careful patient selection, but recurrences may remain indolent. If recurrences are progressive, they may still be amenable to additional medical or surgical therapy. A national or international consensus between oncologists and transplant specialists regarding the indications for liver transplantation is vital, because future progress will depend on careful patient selection and prospective study. |
| Idioma: | Inglés |
1 Massage Therapy for Cancer Patients: A Reciprocal Relationship Between Body and Mind por Sagar, Stephen,Dryden, Trish; Centre for Applied Research, Centennial College,Wong, Raimond K; McMaster University, Departments of Medicine and Oncology | 6 |
2 Chinese Medicine and Biomodulation in Cancer Patients (Part Two) por Sagar, Stephen M,Wong, Raimond K | 7 Cord stem-cell transplantation in Ontario: do we need a public bank? por Gassas, A.; the Hospital for Sick Children, Toronto |
3 Integrating Science and Human Values for Cancer Patient Care por Sutcliffe, Simon B.; BC Cancer Agency | 8 Assessment and management of febrile neutropenia in emergency departments within a regional health authority—a benchmark analysis por Szwajcer, D.; University of Manitoba,Czaykowski, P.; University of Manitoba,Turner, D.; CancerCare Manitoba |
4 Conservative Treatment of Invasive Bladder Cancer por Souhami, Luis; McGill University,Rene, Nicholas,Cury, Fabio Biagini | 9 What is the optimal management of dysphagia in metastatic esophageal cancer? por Cavallin, F.; Veneto Institute of Oncology,Scarpa, M.; Veneto Institute of Oncology,Cagol, M.; Veneto Institute of Oncology,Alfieri, R.; Veneto Institute of Oncology,Castoro, C.; Veneto Institute of Oncology |
5 A review of the patterns of docetaxel use for hormone-resistant prostate cancer at the Princess Margaret Hospital por Chin, S. N.,Wang, L.,Moore, M.,Sridhar, S. S.; University of Toronto | 10 Responses by breast and prostate cancer patients to out-of-pocket costs in Newfoundland and Labrador por Housser, E.; Newfoundland and Labrador Centre for Health Information,Mathews, M.; Memorial University,LeMessurier, J.; Memorial University,Young, S.; Memorial University,Hawboldt, J.; Memorial University,West, R.; Memorial University |