Single center outcomes from parenchymal-sparing resections and microwave ablations for neuroendocrine tumor liver metastases

Abstract

Background: Reported outcomes after surgical debulking in patients with advanced neuroendocrine tumor liver metastases (NETLM) are sparse.

Methods: NETLM patients that underwent surgical debulking from 2019 to 2021 were reviewed. Trends in perioperative liver function, complications, symptom response, and progression-free survival were examined.

Results: 1069 liver lesions were debulked from 53 patients using a combination of parenchymal-sparing resections (PSR) and ultrasound-guided microwave ablations (MWA). Post-operative transaminitis and thrombocytopenia were common, and severity correlated with increasing number of lesions. Laboratory markers for synthetic liver function did not differ according to the number of lesions debulked. 13% of patients sustained a Clavien-Dindo grade 3 or 4 complication which was not associated with the number of lesions targeted. All patients with preoperative symptoms had improvement after surgery. Median time to progression was 10.9 months.

Conclusions: PSR with MWA for large numbers of NETLM is safe and effective for symptom control and does not affect synthetic liver function.

Keywords: Hepatic debulking; Liver metastases; Microwave ablation; Neuroendocrine tumor; Parenchymal-sparing resection; Progression-free survival.