Neuroendocrine Liver Metastases

  • Irene BargelliniEmail author
  • Caterina Vivaldi
  • Giulia Lorenzoni
  • Lorenzo Fornaro
  • Laura Crocetti

We read with interest the papers of Braat et al. [1] and Zener et al. [2] regarding the results of transarterial treatments in patients with Neuroendocrine Neoplasms (NEN) liver metastases.

Available guidelines in NEN liver metastases acknowledge the role of loco-regional therapies in NENs with liver-predominant disease not responding to systemic therapy, to control tumor growth and symptoms [3]. However, there is a substantial lack of large-scale prospective studies and randomized clinical trials in the setting of loco-regional therapies.

These two studies provide data on large series of patients with NEN of any origin and grade treated either with transarterial chemoembolization (TACE) [2] or with Y90-Radioembolization (RE) [1]. Both studies included a substantial number of patients with intrahepatic tumor load > 50%, extrahepatic disease, functioning lesions and heavily pretreated disease. Despite these unfavorable (and heterogeneous) baseline characteristics, both RE and TACE...


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Conflict of interest

Irene Bargellini received honoraria for speaking at symposia from Bayer, Terumo Europe, Sirtex and BTG and a research grant from BTG. The other authors declare that they have no conflicts of interest.


  1. 1.
    Braat AJAT, Kappadath SC, Ahmadzadehfar H, et al. Radioembolization with 90Y resin microspheres of neuroendocrine liver metastases: International Multicenter Study on efficacy and toxicity. Cardiovasc Interv Radiol. 2019;42(3):413–25. Scholar
  2. 2.
    Zener R, Yoon H, Ziv E, et al. Outcomes after transarterial embolization of neuroendocrine tumor liver metastases using spherical particles of different sizes. Cardiovasc Interv Radiol. 2019;42(4):569–76. Scholar
  3. 3.
    Pavel M, O’Toole D, Costa F, et al. Vienna consensus conference participants. ENETS consensus guidelines update for the management of distant metastatic disease of intestinal, pancreatic, bronchial neuroendocrine neoplasms (NEN) and NEN of unknown primary site. Neuroendocrinology. 2016;103(2):172–85. Scholar
  4. 4.
    Chen JX, Rose S, White SB, et al. Embolotherapy for neuroendocrine tumor liver metastases: prognostic factors for hepatic progression-free survival and overall survival. Cardiovasc Interv Radiol. 2017;40(1):69–80. Scholar
  5. 5.
    Cives M, Strosberg JR. Gastroenteropancreatic neuroendocrine tumors. CA Cancer J Clin. 2018;68(6):471–87. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Department of Diagnostic and Interventional RadiologyPisa University HospitalPisaItaly
  2. 2.Department of Medical OncologyPisa University HospitalPisaItaly

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