Management of neuroendocrine tumor liver metastases

Am J Surg. 2023 Nov;226(5):623-630. doi: 10.1016/j.amjsurg.2023.08.011. Epub 2023 Aug 16.


Background: Neuroendocrine Tumors (NETs) are a group of tumors that arise from neuroendocrine cells, and are increasing in incidence worldwide. These tumors often metastasize to the liver, and management of these neuroendocrine tumor liver metastases (NELMs) requires a multi-disciplinary approach. We aim to provide a comprehensive update for treatment of NELMs.

Methods: We completed a comprehensive systemic review of papers involving the diagnosis, treatment, and outcomes of NELMs. We identified 1612 records via Scopus database literature search. Two independent authors reviewed these records, with 318 meeting criteria for inclusion in the final systemic review.

Results: Primary tumor resection with resection of liver metastases is the treatment of choice for patients with NELMs. Liver-directed therapies and liver transplantation can be considered for patients with unresectable liver metastases. Systemic medical therapy is used for managing tumor burden and symptoms caused by NELMs.

Conclusions: Advancement in liver-directed and targeted systemic therapies provide improved options for patients with unresectable tumors. Given the complexity of NELMs, management of NELMs necessitates multidisciplinary teams at comprehensive health centers.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Hepatectomy
  • Humans
  • Liver Neoplasms* / surgery
  • Neuroendocrine Tumors* / diagnosis
  • Neuroendocrine Tumors* / surgery