Multimodal cytoreduction for carcinoid liver metastases

Analysis of a case series with highly advanced disease

E. Sporn, Gregory Mancini, Y. Khajanchee, Ch Wilson, P. D. Hansen, L. L. Swanstrom, Klaus Thaler

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The objective of our study was to assess the efficacy of multimodal hepatic cytoreduction in symptomatic patients with advanced hepatic metastases from carcinoid disease. Methods: A retrospective analysis of prospectively collected data was performed. All consecutive patients, who underwent cytoreductive treatment for their metastatic carcinoid liver disease between October 1996 and October 2004, were enrolled. Treatment modalities included resection, radiofrequency with ethanol ablation, chemoembolization, or combined therapy. Results: Fifteen patients, mean age 61 (SD 11) years, underwent cytoreduction. Twelve (80%) patients had extensive bilobar disease and 3 (20%) had solitary lesions. Eleven patients underwent one or more palliative surgical debulking procedures. Two patients had curative resection, and 2 patients had chemoembolization only due to unacceptable anesthesia risk. With a mean follow-up after 29 months (SD 22.1), 6 patients (40%) had stable disease, 8 (53.3%) had progression of disease and 1 (6.6%) had no disease at all. Death grasped 4 patients of which 2 died due to progression of disease. The median symptom relief period was 12 months. Overall survival was 57 months (mean) from the time of hepatic cytoreduction. Conclusions: Aggressive hepatic cytoreduction in patients with advanced metastatic carcinoid disease can achieve excellent overall survival but needs improvement in long-term symptom control.

Original languageEnglish (US)
Pages (from-to)72-76
Number of pages5
JournalEuropean Surgery - Acta Chirurgica Austriaca
Volume40
Issue number2
DOIs
StatePublished - May 21 2008

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Carcinoid Tumor
Neoplasm Metastasis
Liver
Disease Progression
Survival
Liver Diseases
Ethanol
Therapeutics
Anesthesia

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Multimodal cytoreduction for carcinoid liver metastases : Analysis of a case series with highly advanced disease. / Sporn, E.; Mancini, Gregory; Khajanchee, Y.; Wilson, Ch; Hansen, P. D.; Swanstrom, L. L.; Thaler, Klaus.

In: European Surgery - Acta Chirurgica Austriaca, Vol. 40, No. 2, 21.05.2008, p. 72-76.

Research output: Contribution to journalArticle

Sporn, E. ; Mancini, Gregory ; Khajanchee, Y. ; Wilson, Ch ; Hansen, P. D. ; Swanstrom, L. L. ; Thaler, Klaus. / Multimodal cytoreduction for carcinoid liver metastases : Analysis of a case series with highly advanced disease. In: European Surgery - Acta Chirurgica Austriaca. 2008 ; Vol. 40, No. 2. pp. 72-76.
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abstract = "Background: The objective of our study was to assess the efficacy of multimodal hepatic cytoreduction in symptomatic patients with advanced hepatic metastases from carcinoid disease. Methods: A retrospective analysis of prospectively collected data was performed. All consecutive patients, who underwent cytoreductive treatment for their metastatic carcinoid liver disease between October 1996 and October 2004, were enrolled. Treatment modalities included resection, radiofrequency with ethanol ablation, chemoembolization, or combined therapy. Results: Fifteen patients, mean age 61 (SD 11) years, underwent cytoreduction. Twelve (80{\%}) patients had extensive bilobar disease and 3 (20{\%}) had solitary lesions. Eleven patients underwent one or more palliative surgical debulking procedures. Two patients had curative resection, and 2 patients had chemoembolization only due to unacceptable anesthesia risk. With a mean follow-up after 29 months (SD 22.1), 6 patients (40{\%}) had stable disease, 8 (53.3{\%}) had progression of disease and 1 (6.6{\%}) had no disease at all. Death grasped 4 patients of which 2 died due to progression of disease. The median symptom relief period was 12 months. Overall survival was 57 months (mean) from the time of hepatic cytoreduction. Conclusions: Aggressive hepatic cytoreduction in patients with advanced metastatic carcinoid disease can achieve excellent overall survival but needs improvement in long-term symptom control.",
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