TY - JOUR
T1 - Treatment of Liver Metastases from Midgut Neuroendocrine Tumours: A Systematic Review and Meta-Analysis
T2 - A systematic review and meta-analysis
AU - Kaçmaz, Enes
AU - Heidsma, Charlotte M.
AU - Besselink, Marc G. H.
AU - Dreijerink, Koen M. A.
AU - Klümpen, Heinz-Josef
AU - van Dijkum, Elisabeth J. M. Nieveen
AU - Engelsman, Anton F.
N1 - Publisher Copyright: © 2019 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2019/3/22
Y1 - 2019/3/22
N2 - Strong evidence comparing different treatment options for liver metastases (LM) arising from gastroenteropancreatic neuroendocrine tumours (GEP-NET) is lacking. The aim of this study was to determine which intervention for LMs from GEP-NETs shows the longest overall survival (OS). A systematic search was performed in MEDLINE, Embase and the Cochrane Library in February 2018. Studies reporting on patients with LMs of any grade of sporadic GEP-NET comparing two intervention groups were included for analysis. Meta-analyses were performed where possible. Eleven studies, with a total of 1108, patients were included; 662 patients had LM from pancreatic NETs (pNET), 164 patients from small-bowel NETs (SB-NET) and 282 patients of unknown origin. Improved 5-year OS was observed for surgery vs. chemotherapy (OR 0.05 95% CI [0.01, 0.21] p < 0.0001), for surgery vs. embolization (OR 0.18 95% CI [0.05, 0.61] p = 0.006) and for LM resection vs. no LM resection (OR 0.15 95% CI [0.05, 0.42] p = 0.0003). This is the largest meta-analysis performed comparing different interventions for LMs from GEP-NETs. Despite the high risk of bias and heterogeneity of data, surgical resection for all tumour grades results in the longest overall survival. Chemotherapy and embolization should be considered as an alternative in case surgery is not feasible.
AB - Strong evidence comparing different treatment options for liver metastases (LM) arising from gastroenteropancreatic neuroendocrine tumours (GEP-NET) is lacking. The aim of this study was to determine which intervention for LMs from GEP-NETs shows the longest overall survival (OS). A systematic search was performed in MEDLINE, Embase and the Cochrane Library in February 2018. Studies reporting on patients with LMs of any grade of sporadic GEP-NET comparing two intervention groups were included for analysis. Meta-analyses were performed where possible. Eleven studies, with a total of 1108, patients were included; 662 patients had LM from pancreatic NETs (pNET), 164 patients from small-bowel NETs (SB-NET) and 282 patients of unknown origin. Improved 5-year OS was observed for surgery vs. chemotherapy (OR 0.05 95% CI [0.01, 0.21] p < 0.0001), for surgery vs. embolization (OR 0.18 95% CI [0.05, 0.61] p = 0.006) and for LM resection vs. no LM resection (OR 0.15 95% CI [0.05, 0.42] p = 0.0003). This is the largest meta-analysis performed comparing different interventions for LMs from GEP-NETs. Despite the high risk of bias and heterogeneity of data, surgical resection for all tumour grades results in the longest overall survival. Chemotherapy and embolization should be considered as an alternative in case surgery is not feasible.
KW - liver metastases
KW - meta-analysis
KW - midgut
KW - pancreatic neuroendocrine tumours
KW - small bowel neuroendocrine tumours
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85079129975&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30909512
UR - http://www.scopus.com/inward/record.url?scp=85079129975&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/jcm8030403
DO - https://doi.org/10.3390/jcm8030403
M3 - Review article
C2 - 30909512
SN - 2077-0383
VL - 8
JO - Journal of clinical medicine
JF - Journal of clinical medicine
IS - 3
M1 - 403
ER -