Surgical strategy for neuroendocrine liver metastases

Introduction There are no established strategies for the surgical management of neuroendocrine liver metastases. Surgical treatment options include liver resection, liver transplantation and debulking hepatectomy. Other liver‐directed therapies include local ablation and transarterial embolization. Aim In the present review, we discuss the outcomes of the different surgical treatment modalities for neuroendocrine liver metastases. Patients and methods A review of the published literature on the surgical management of neuroendocrine liver metastases was undertaken. Results Liver resection is the curative treatment of choice for patients with grade 1 or 2 liver metastases without concurrent extra‐hepatic disease. Liver transplantation is another potentially curative therapy. Debulking hepatectomy might be indicated for symptomatic neuroendocrine liver disease, whereas liver ‐directed local ablative and trans‐arterial treatments should be considered for patients not suitable for liver resection or transplantation. Conclusions Hepatectomy and liver transplanatation should be offered to patients with resectable neuroendocrine liver metastases in the absence of extrahepatic metastases.