Management and outcomes of patients with recurrent neuroendocrine liver metastasis after curative surgery: An international multi‐institutional analysis

Objective We sought to characterize the treatment, as well as define the long‐term outcomes, of patients with recurrent neuroendocrine liver metastasis (NELM). Methods Between 1990 and 2014, 322 patients undergoing curative intent liver surgery for NELM were identified from a multi‐institutional database. Recurrences were classified as intrahepatic, extrahepatic, and both intra‐ and extra‐hepatic. Results Overall, median, 1‐, 5‐, 10‐year DFS were 3.1 years, 75.5%, 40.4%, and 32.1%, respectively. After curative intent liver surgery, 209 patients (64.9%) recurred within a median follow‐up of 4.5 years, while 113 (35.1%) patients were alive without disease with a follow‐up time ≥3 years. The site of recurrence was intrahepatic only (n = 111, 65.7%), extrahepatic only (n = 19, 11.2%), or intra‐ and extra‐hepatic (n = 39, 23.1%). Compared with intrahepatic only recurrence, extrahepatic only, and combined intra‐ and extra‐hepatic recurrence were associated with a worse long‐term outcome (10‐year OS: intrahepatic only, 42.5%, 95%CI, 24.9‐59.0 vs extrahepatic only, 0% and combined intra‐ and extra‐hepatic, 21.5%, 95%CI, 5.3‐44.0) (P