Prospective study of chemoembolization (CE) of liver metastases from endocrine tumors. A report of 15 cases

1994 ◽  
Vol 4 (1) ◽  
Author(s):  
Paul Legmann ◽  
Philippe Ruszniewski ◽  
Samir Hochlaf ◽  
Michel Mignon
Keyword(s):  
Prospective Study ◽  
Liver Metastases ◽  
Endocrine Tumors

scholarly journals Prospective Study of the Natural History of Gastrinoma in Patients with MEN1: Definition of an Aggressive and a Nonaggressive Form

2001 ◽  
Vol 86 (11) ◽  
pp. 5282-5293 ◽  
Author(s):  
Fathia Gibril ◽  
David J. Venzon ◽  
Jeremiah V. Ojeaburu ◽  
Showkat Bashir ◽  
Robert T. Jensen
Keyword(s):  
Natural History ◽  
Tumor Growth ◽  
Prospective Study ◽  
Liver Metastases ◽  
Hepatic Metastases ◽  
Endocrine Tumors ◽  
Zollinger Ellison Syndrome ◽  
Pancreatic Endocrine Tumors ◽  
History Of ◽  
Aggressive Tumor

The natural history of pancreatic endocrine tumors (PETs) in patients with MEN1 is largely unknown. Recent studies in patients with sporadic PETs show that in a subset, tumor growth is aggressive. To determine whether PETs in patients with MEN1 show similar growth behavior, we report results from a long-term prospective study of 57 patients with MEN1 and Zollinger-Ellison syndrome. All patients had tumor imaging studies yearly, and the mean follow-up was 8 yr. Only patients with PETs 2.5 cm or larger underwent abdominal surgical exploration. Hepatic metastases occurred in 23%, and in 14% tumors demonstrated aggressive growth. Three tumor-related deaths occurred, each due to liver metastases, and in each, aggressive tumor growth was present. Overall, 4% of the study group, 23% with liver metastases and 38% with aggressive disease, died. Aggressive growth was associated with higher gastrins and larger tumors. Patients with liver metastases with aggressive growth differed from those with liver metastases without aggressive growth in age at MEN1 onset or diagnosis and primary tumor size. Survival was decreased (P = 0.0012) in patients with aggressive tumor growth compared with those with liver metastases without aggressive growth or with no liver metastases without aggressive growth. Based on these results a number of factors were identified that may be clinically useful in determining in which patients aggressive tumor growth may occur. These results demonstrate in a significant subset of patients with MEN1 and Zollinger-Ellison syndrome, aggressive tumor growth occurs and can lead to decreased survival. The identification of prognostic factors that identify this group will be important clinically in allowing more aggressive treatment options to be instituted earlier.

scholarly journals Liver metastases of MEN1 related duodenopancreatic neuro-endocrine tumors; strategies and outcomes

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e61 ◽  
Author(s):  
S. Nell ◽  
E.B. Conemans ◽  
J.M. de Laat ◽  
C.R. Pieterman ◽  
I.H.M. Borel Rinkes ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Endocrine Tumors

Ablative therapies for liver metastases of digestive endocrine tumours.

2003 ◽  
pp. 463-468 ◽  
Author(s):  
D O'Toole ◽  
F Maire ◽  
P Ruszniewski
Keyword(s):  
Liver Metastases ◽  
Somatostatin Analogs ◽  
Hepatic Metastases ◽  
Vascular Occlusion ◽  
Treatment Method ◽  
Vascular Tumors ◽  
Endocrine Tumors ◽  
Hepatic Ischemia ◽  
Ablative Therapies

Hepatic metastases are frequently encountered in patients with digestive endocrine tumors and their presence plays an important role in quality of life and overall prognosis. Surgery is the treatment method of choice for hepatic metastases but this is frequently impossible due to the extent of disease. Systemic chemotherapy is offered to patients with diffuse and/or progressive liver metastases but results are disappointing especially in patients with metastases of midgut origin. In the latter patients with carcinoid syndrome, somatostatin analogs are frequently initially effective but their efficacy wanes due to disease progression and development of tachyphylaxis. Other therapeutic options in the treatment of hepatic metastases are locoregional strategies where vascular occlusion induces ischemia in these highly vascular tumors using either surgical or radiological techniques. Available methods include surgical ligation of the hepatic artery, transient hepatic ischemia or sequential hepatic arterialization. Trans-catheter arterial chemoembolization has proven effective in terms of long palliation and objective tumor responses. Other treatments aimed at regional destruction either alone or in combination with surgery include radiofrequency ablation and cryotherapy. The latter are usually important adjuncts to surgery and are usually reserved for limited disease.

Liver resection (and associated extrahepatic resections) for metastatic well-differentiated endocrine tumors: A 15-year single center prospective study

Surgery ◽  
2003 ◽  
Vol 133 (4) ◽  
pp. 375-382 ◽  
Author(s):  
Dominique Elias ◽  
Philippe Lasser ◽  
Michel Ducreux ◽  
Pierre Duvillard ◽  
Jean-Francois Ouellet ◽  
...  
Keyword(s):  
Liver Resection ◽  
Prospective Study ◽  
Endocrine Tumors ◽  
Single Center ◽  
Well Differentiated

Bone metastases in patients with gastrinomas: a prospective study of bone scanning, somatostatin receptor scanning, and magnetic resonance image in their detection, frequency, location, and effect of their detection on management.

1998 ◽  
Vol 16 (3) ◽  
pp. 1040-1053 ◽  
Author(s):  
F Gibril ◽  
J L Doppman ◽  
J C Reynolds ◽  
C C Chen ◽  
V E Sutliff ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Liver Metastases ◽  
Bone Metastases ◽  
Bone Scan ◽  
Somatostatin Receptor ◽  
Axial Skeleton ◽  
Bone Lesions ◽  
Endocrine Tumors ◽  
Bone Scanning ◽  
Imaging Results

PURPOSE To determine whether bone scan, magnetic resonance imaging (MRI), or somatostatin receptor scintigraphy (SRS) is best for identifying bone metastases in patients with gastrinomas, as well as their frequency and location, whether their detection affects management, and what patient subgroups should be examined. MATERIALS AND METHODS One hundred fifteen patients with gastrinoma were prospectively studied. Patients were examined yearly and those with liver metastases were reexamined every 3 months. Based on clinical history, histology, growth pattern, and development of new bone lesions, possible bone metastases were classified as to whether they were or were not bone metastases. Imaging results were correlated at different times in the disease course and with disease extent. RESULTS Bone scan was positive in 52 patients, MRI in seven, and SRS in six. Eight patients (7%) were determined to have bone metastases and MRI was correctly positive in seven, SRS in six, and bone scan in five. SRS or MRI was positive in all patients with bone metastases. Bone scan had significantly lower specificity and sensitivity, and a higher rate (P < .02) of false-negative results than MRI or SRS. Bone metastases occurred in 31% of patients with liver metastases and 0% with only lymph node metastases. The initial bone metastases were in the spine or sacrum (75%) followed in descending order by the pelvis or sacroiliac joints (38%), scapula or shoulder, and ribs. In all cases, detection of bone metastases changed the management. CONCLUSION SRS and MRI, because of high sensitivity and specificity, are recommended over bone scanning to screen for bone metastases in patients with gastrinomas. However, because bone metastases can occur initially outside the axial skeleton, SRS is the recommended initial localization method of choice. Bone metastases occur in 7% of all patients and 31% of patients with liver metastases, only occur in patients with liver metastases, are usually in the axial skeleton initially, and their detection changes management in all cases. Patients with pancreatic endocrine tumors with liver metastases should undergo SRS every 6 months to 1 year to detect bone metastases.

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