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Neuroendocrine Peritoneal Metastases

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Neuroendocrine Tumors

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Abstract

Peritoneal carcinomatosis (PC) from neuroendocrine tumors (NET) will occur in 10–33% of patients with the majority of these originating from a midgut NET. The presence of PC is frequently associated with advanced disease, including liver and lymph node metastases. Recently, Gallium-68 DOTATATE PET/CT scans have replaced octreotide scans for identification and staging of these lesions. The optimal surgical management of these lesions is unknown and is far from standardized. The only potentially curative surgical operation is resection of both the primary and all metastatic disease, which can be difficult to achieve. Cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) has been investigated as potential options to improve long-term survival. The overall survival outcomes for these patients remain better than in patients with PC from other histologies, and appropriate management can lead to improved survival and quality of life.

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References

  1. Elias D, Lasser P, Ducreux M, Duvillard P, Ouellet JF, Dromain C, et al. Liver resection (and associated extrahepatic resections) for metastatic well-differentiated endocrine tumors: a 15-year single center prospective study. Surgery. 2003;133(4):375–82.

    Article  PubMed  Google Scholar 

  2. Norlen O, Stalberg P, Oberg K, Eriksson J, Hedberg J, Hessman O, et al. Long-term results of surgery for small intestinal neuroendocrine tumors at a tertiary referral center. World J Surg. 2012;36(6):1419–31.

    Article  PubMed  Google Scholar 

  3. Elias D, Sideris L, Liberale G, Ducreux M, Malka D, Lasser P, et al. Surgical treatment of peritoneal carcinomatosis from well-differentiated digestive endocrine carcinomas. Surgery. 2005;137(4):411–6.

    Article  PubMed  Google Scholar 

  4. Vasseur B, Cadiot G, Zins M, Flejou JF, Belghiti J, Marmuse JP, et al. Peritoneal carcinomatosis in patients with digestive endocrine tumors. Cancer. 1996;78(8):1686–92.

    Article  CAS  PubMed  Google Scholar 

  5. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003;97(4):934–59.

    Article  PubMed  Google Scholar 

  6. Lee MR, Harris C, Baeg KJ, Aronson A, Wisnivesky JP, Kim MK. Incidence trends of gastroenteropancreatic neuroendocrine tumors in the United States. Clin Gastroenterol Hepatol. 2019;17(11):2212–2217.e1.

    Article  PubMed  Google Scholar 

  7. Norlen O, Edfeldt K, Akerstrom G, Westin G, Hellman P, Bjorklund P, et al. Peritoneal carcinomatosis from small intestinal neuroendocrine tumors: clinical course and genetic profiling. Surgery. 2014;156(6):1512. https://doi.org/10.1016/j.surg.2014.08.090.

    Article  PubMed  Google Scholar 

  8. Lollgen RM, Hessman O, Szabo E, Westin G, Akerstrom G. Chromosome 18 deletions are common events in classical midgut carcinoid tumors. Int J Cancer. 2001;92(6):812–5. https://doi.org/10.1002/ijc.1276.

    Article  CAS  PubMed  Google Scholar 

  9. Kytola S, Hoog A, Nord B, Cedermark B, Frisk T, Larsson C, et al. Comparative genomic hybridization identifies loss of 18q22-qter as an early and specific event in tumorigenesis of midgut carcinoids. Am J Pathol. 2001;158(5):1803–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Andersson E, Sward C, Stenman G, Ahlman H, Nilsson O. High-resolution genomic profiling reveals gain of chromosome 14 as a predictor of poor outcome in ileal carcinoids. Endocr Relat Cancer. 2009;16(3):953–66.

    Article  PubMed  Google Scholar 

  11. Au JT, Levine J, Aytaman A, Weber T, Serafini F. Management of peritoneal metastasis from neuroendocrine tumors. J Surg Oncol. 2013;108(6):385–6.

    Article  PubMed  Google Scholar 

  12. Schuitevoerder D, Plana A, Izquierdo FJ, Lambert LA, Keutgen XM, Deneve JL, et al. The Chicago consensus on peritoneal surface malignancies: Management of Neuroendocrine Tumors. Ann Surg Oncol. 2020;27(6):1788–92.

    Article  Google Scholar 

  13. Tirosh A, Kebebew E. The utility of 68Ga-DOTATATE positron-emission tomography/computed tomography in the diagnosis, management, follow-up and prognosis of neuroendocrine tumors. Future Oncol. 2018;14(2):111–22.

    Article  CAS  PubMed  Google Scholar 

  14. Crown A, Rocha FG, Raghu P, Lin B, Funk G, Alseidi A, et al. Impact of initial imaging with gallium-68 dotatate PET/CT on diagnosis and management of patients with neuroendocrine tumors. J Surg Oncol. 2020;121(3):480–5.

    Article  CAS  PubMed  Google Scholar 

  15. Hofman MS, Eddie Lau WF, Hicks RJ. Somatostatin receptor imaging with68Ga DOTATATE PET/CT: clinical utility, normal patterns, pearls, and pitfalls in interpretation1. Radiographics. 2015;35(2):500–16.

    Article  PubMed  Google Scholar 

  16. Fox DJ, Khattar RS. Carcinoid heart disease: presentation, diagnosis, and management. Heart. 2004;90(10):1224–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Mansencal N, Mitry E, Bachet JB, Rougier P, Dubourg O. Echocardiographic follow-up of treated patients with carcinoid syndrome. Am J Cardiol. 2010;105(11):1588–91.

    Article  PubMed  Google Scholar 

  18. Lillegard JB, Fisher JE, McKenzie TJ, Que FG, Farnell MB, Kendrick ML, et al. Hepatic resection for the carcinoid syndrome in patients with severe carcinoid heart disease: does valve replacement permit safe hepatic resection? J Am Coll Surg. 2011;213(1):130–6.

    Article  PubMed  Google Scholar 

  19. Kinney MA, Warner ME, Nagorney DM, Rubin J, Schroeder DR, Maxson PM, et al. Perianaesthetic risks and outcomes of abdominal surgery for metastatic carcinoid tumours. Br J Anaesth. 2001;87(3):447–52.

    Article  CAS  PubMed  Google Scholar 

  20. Kinney MA, Nagorney DM, Clark DF, O’Brien TD, Turner JD, Marienau ME, et al. Partial hepatic resections for metastatic neuroendocrine tumors: perioperative outcomes. J Clin Anesth. 2018;51:93–6.

    PubMed  Google Scholar 

  21. Kianmanesh R, Ruszniewski P, Rindi G, Kwekkeboom D, Pape UF, Kulke M, et al. ENETS consensus guidelines for the management of peritoneal carcinomatosis from neuroendocrine tumors. Neuroendocrinology. 2010;91(4):333–40.

    Article  CAS  PubMed  Google Scholar 

  22. Gilly FN, Carry PY, Sayag AC, Brachet A, Panteix G, Salle B, et al. Regional chemotherapy (with mitomycin C) and intra-operative hyperthermia for digestive cancers with peritoneal carcinomatosis. Hepato-Gastroenterology. 1994;41(2):124–9.

    CAS  PubMed  Google Scholar 

  23. Llueca A, Serra A, Rivadulla I, Gomez L, Escrig J, Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery. Prediction of suboptimal cytoreductive surgery in patients with advanced ovarian cancer based on preoperative and intraoperative determination of the peritoneal carcinomatosis index. World J Surg Oncol. 2018;16(1):37.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Chia CS, You B, Decullier E, Vaudoyer D, Lorimier G, Abboud K, et al. Patients with peritoneal carcinomatosis from gastric cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: is cure a possibility? Ann Surg Oncol. 2016;23(6):1971–9.

    Article  CAS  PubMed  Google Scholar 

  25. Ng JL, Ong WS, Chia CS, Tan GH, Soo KC, Teo MC. Prognostic relevance of the peritoneal surface disease severity score compared to the peritoneal cancer index for colorectal peritoneal carcinomatosis. Int J Surg Oncol. 2016;2016:2495131.

    PubMed  PubMed Central  Google Scholar 

  26. Chan DL, Dixon M, Law CH, Koujanian S, Beyfuss KA, Singh S, et al. Outcomes of cytoreductive surgery for metastatic low-grade neuroendocrine tumors in the setting of Extrahepatic metastases. Ann Surg Oncol. 2018;25(6):1768–74.

    Article  PubMed  Google Scholar 

  27. Tsang ES, McConnell YJ, Schaeffer DF, Lee L, Yin Y, Zerhouni S, et al. Outcomes of surgical and chemotherapeutic treatments of goblet cell carcinoid Tumors of the appendix. Ann Surg Oncol. 2018;25(8):2391–9.

    Article  PubMed  Google Scholar 

  28. Wonn SM, Limbach KE, Pommier SJ, Ratzlaff AN, Leon EJ, McCully BH, et al. Outcomes of cytoreductive operations for peritoneal carcinomatosis with or without liver cytoreduction in patients with small bowel neuroendocrine tumors. Surgery. 2020;S0039-6060(20):30174–30174.

    Google Scholar 

  29. Goéré D, Passot G, Gelli M, Levine EA, Bartlett DL, Sugarbaker PH, et al. Complete cytoreductive surgery plus HIPEC for peritoneal metastases from unusual cancer sites of origin: results from a worldwide analysis issue of the Peritoneal Surface Oncology Group International (PSOGI). Int J Hyperth. 2017;33(5):520–7.

    Article  Google Scholar 

  30. Elias D, David A, Sourrouille I, Honore C, Goere D, Dumont F, et al. Neuroendocrine carcinomas: optimal surgery of peritoneal metastases (and associated intra-abdominal metastases). Surgery. 2014;155(1):5–12.

    Article  PubMed  Google Scholar 

  31. Kuijpers AM, Hauptmann M, Aalbers AG, Nienhuijs SW, de Hingh IH, Wiezer MJ, et al. Cytoreduction and hyperthermic intraperitoneal chemotherapy: the learning curve reassessed. Eur J Surg Oncol. 2016;42(2):244–50.

    Article  CAS  PubMed  Google Scholar 

  32. Polanco PM, Ding Y, Knox JM, Ramalingam L, Jones H, Hogg ME, et al. Institutional learning curve of cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion for peritoneal malignancies. Ann Surg Oncol. 2015;22(5):1673–9.

    Article  PubMed  Google Scholar 

  33. Kusamura S, Baratti D, Virzì S, Bonomi S, Iusco DR, Grassi A, et al. Learning curve for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal surface malignancies: analysis of two centres. J Surg Oncol. 2013;107(4):312–9.

    Article  PubMed  Google Scholar 

  34. Bao P, Bartlett D. Surgical techniques in visceral resection and peritonectomy procedures. Cancer J. 2009;15(3):204–11.

    Article  PubMed  Google Scholar 

  35. Mehta SS, Bhatt A, Glehen O. Cytoreductive surgery and peritonectomy procedures. Indian J Surg Oncol. 2016;7(2):139–51.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Sugarbaker PH. Cytoreductive surgery & perioperative chemotherapy for peritoneal surface malignancy: textbook and video atlas. 2nd ed. Woodury: Cine-Med Publishing; 2012.

    Google Scholar 

  37. Rinke A, Müller HH, Schade-Brittinger C, Klose KJ, Barth P, Wied M, et al. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID study group. J Clin Oncol. 2009;27(28):4656–63.

    Article  CAS  PubMed  Google Scholar 

  38. Caplin ME, Pavel M, Ćwikła JB, Phan AT, Faderer M, Sedlackova E, et al. Lanreotide in metastatic enteropancreatic neuroendocrine tumors. N Engl J Med. 2014;371(3):224–33.

    Article  PubMed  CAS  Google Scholar 

  39. Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, et al. Phase 3 trial of 177 Lu-dotatate for midgut neuroendocrine tumors. N Engl J Med. 2017;376(2):125–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Bekes I, Friedl TWP, Köhler T, Mobus V, Janni W, Wockel A, et al. Does VEGF facilitate local tumor growth and spread into the abdominal cavity by suppressing endothelial cell adhesion, thus increasing vascular peritoneal permeability followed by ascites production in ovarian cancer? Mol Cancer. 2016;15:13.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  41. Fushida S, Oyama K, Kinoshita J, Yagi Y, Okamoto K, Tajima H, et al. VEGF is a target molecule for peritoneal metastasis and malignant ascites in gastric cancer: prognostic significance of VEGF in ascites and efficacy of anti-VEGF monoclonal antibody. Onco Targets Ther. 2013;6:1445–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Raymond E, Dahan L, Raoul JL, Bang YJ, Borbath I, Lombard-Bohas C, et al. Sunitinib malate for the treatment of pancreatic neuroendocrine Tumors. N Engl J Med. 2011;364(6):501–13.

    Article  CAS  PubMed  Google Scholar 

  43. Faivre S, Niccoli P, Castellano D, Valle JW, Hammel P, Raoul JL, et al. Sunitinib in pancreatic neuroendocrine tumors: updated progression-free survival and final overall survival from a phase III randomized study. Ann Oncol. 2017;28(2):339–43.

    Article  CAS  PubMed  Google Scholar 

  44. Shiozaki H, Elimova E, Slack RS, Chen HC, Staerkel GA, Sneige N, et al. Prognosis of gastric adenocarcinoma patients with various burdens of peritoneal metastases. J Surg Oncol. 2016;113(1):29–35.

    Article  PubMed  Google Scholar 

  45. Glockzin G, Schlitt HJ, Piso P. Peritoneal carcinomatosis: patients selection, perioperative complications and quality of life related to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Surg Oncol. 2009;7:5.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Cotte E, Passot G, Gilly FN, Glehen O. Selection of patients and staging of peritoneal surface malignancies. World J Gastrointest Oncol. 2010;2(1):31–5.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Hepatobiliary and Pancreatic Surgery, Mayo Clinic, Rochester, MN, USA

    Jennifer L. Leiting & Travis E. Grotz

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  1. Jennifer L. Leiting
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Correspondence to Jennifer L. Leiting .

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Editors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Jordan M. Cloyd

  2. Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Timothy M. Pawlik

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Leiting, J.L., Grotz, T.E. (2021). Neuroendocrine Peritoneal Metastases. In: Cloyd, J.M., Pawlik, T.M. (eds) Neuroendocrine Tumors. Springer, Cham. https://doi.org/10.1007/978-3-030-62241-1_18

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  • DOI: https://doi.org/10.1007/978-3-030-62241-1_18

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