Original CommunicationsLiver resection (and associated extrahepatic resections) for metastatic well-differentiated endocrine tumors: A 15-year single center prospective study*,**
Section snippets
Patients and methods
From January, 1985, to January, 2000, 112 patients treated in the Gustave-Roussy Institute for liver metastases from WDET origin were considered for hepatectomy. The inclusion criteria were: (1) complete resection of the tumor(s) seemed possible and was the primary objective; (2) primary tumor and regional lymph nodes had been previously resected or were potentially resectable, and the metastatic disease was confined to the liver or associated with resectable extrahepatic localization(s); (3)
Mortality-morbidity
Two deaths (secondary to pancreatitis and to hemorrhage) occurred postoperatively (5%) in patients with large primary pancreatic tumors (20 cm and 16 cm of diameter, respectively) and segmental portal hypertension. Both patients required difficult distal pancreatectomy and splenectomy because of extensive local tumor infiltration. Morbidity including minor complications was 45%; 22 complications were observed in 21 patients (including those who died) and are reported in Table III.
Discussion
In patients with metastases from WDET, the treatment indications and impact remain poorly defined because of the low incidence of these tumors, the heterogeneous presentation, and the relatively long natural history even in presence of advanced disease. In spite of their reputation as slow-growing tumors, the analysis of the 8305 patients with carcinoid tumors collected in 2 US surveillance and epidemiologic programs revealed that only 22% of patients with distant metastases remain alive at 5
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Reprint requests: Elias Dominique, MD, PhD, Chief of Service, Department of Oncologic Surgery, Institut Gustave Roussy, Rue Camille Desmoulins, 94805, Villejuif, Cedex, France.
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0039-6060/2003/$30.00 + 0