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Radioembolization for neuroendocrine liver metastases is safe and effective prior to major hepatic resection

Hepatobiliary Surgery and Nutrition 2020年第3期9卷 312-321页

作者： Florian Bosch Harun Ilhan vanessa pfahler Michael Thomas Thomas Knosel Valentin Eibl Sebastian Pratschke Peter Bartenstein Max Seidensticker Christoph J.Auernhammer Christine Spitzweg Markus O.Guba Jens Werner Martin K.Angele Department of General Visceraland Transplant SurgeryLudwig-Maximilians-University MunichMunichGermany Interdisciplinary Center of Neuroendocrine Tumors of the Gastro Entero Pancreatic System Ludwig-Maximilians-University MunichMunichGermany Department of Nuclear Medicine University HospitalLudwig-Maximilians-University MunichMunichGermany Department of Radiology Ludwig-Maximilians-University MunichMunichGermany Institute of Pathology Ludwig-Maximilians-University MunichMunichGermany Department of Internal Medicine 4 Ludwig-Maximilians-University MunichMunichGermany

Background:Radioembolization(RE)is well established in the treatment of neuroendocrine liver *** surgery is rarely performed after RE,although liver resection is the gold standard in the treatment of localized neuroendocrine liver ***,aim of the present study was to evaluate the safety and feasibility of liver resection after RE in a homogenous ***:From a prospective surgical(n=494)and nuclear medical(n=138)database patients with NELM who underwent liver resection and/or RE were *** September 2011 and December 2017 eight patients could be identified who underwent liver resection after RE(mean therapeutic activity of 1,746 Mbq).Overall and progression free survival were evaluated as well as epidemiological and perioperative *** surgical specimens were analyzed for necrosis,fibrosis,inflammation,and ***:The mean hepatic tumor load of patients,who had liver surgery after RE,was 31.4%with a mean Ki-67 proliferation index of 5.9%.The majority of these patients(7/8)received whole liver RE prior to liver resection,which did not increase morbidity and mortality compared to a surgical *** for RE were oncological(6/8)or carcinoid syndrome associated reasons(2/8).Mean overall survival was 25.1 months after RE and subsequent *** necrosis in radioembolized lesions was 29.4%without evidence of fibrosis and inflammation in hepatic ***:This is the first study analyzing the multimodal therapeutic approach of liver resection following whole liver *** treatment algorithm is safe,does not lead to an increased morbidity and is associated with a favorable oncological ***,patient selection remains a key issue.

关键词： Radioembolization(RE) neuroendocrine tumor liver surgery

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