Skip to main content

Locoregional Therapies of NEN

  • Chapter
  • First Online:
Neuroendocrine Neoplasia Management
  • 632 Accesses

Abstract

Interventional Oncology (IO) is nowadays one of the four pillars of the modern Oncology, together with Clinical Oncology, Surgical Oncology, and Radiation Therapy, thanks to the several minimally invasive therapies provided and available both for radical and palliative purposes. Within the field of Neuroendocrine Tumors, IO plays an important role in the management of patients with liver metastases, where intra-arterial therapies, such as embolization, chemoembolization, and radioembolization, as well as percutaneous interventions, such as radiofrequency ablation and microwave ablation, are the more common options included into the treatment strategies. Intra-arterial options, originally introduced for treating HCC in clinical practice, gained attention in liver metastatic NET because of the outstanding results in symptoms control and for prolonging survival, with no or few side effects. On the other hand, liver ablation, firstly introduced for percutaneous imaging-guided approach and more recently also applied in open and laparoscopic setting, can provide eradication of liver metastases with less invasiveness than traditional surgery. Moreover, due to the high rate of relapse after radical treatments, new liver metastases can be further eradicated with percutaneous ablation, with no cumulative toxicity such as with repeated resections. For those reasons, a modern management of patients affected by Neuroendocrine Tumors cannot avoid to include the Interventional Oncology options within the discussion of dedicated Multidisciplinary Tumor Board.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Ito T, Lee L, Jensen RT. Treatment of symptomatic neuroendocrine tumor syndromes: recent advances and controversies. Expert Opin Pharmacother. 2016;17(16):2191–205.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Jensen RT, Norton JA, Oberg K. Neuroendocrine tumors. In: Feldman M, Friedman LS, Brandt LJ, editors. Sleisenger and Fordtran’s gastrointestinal and liver diseases. Philadelphia: Elsevier Saunders. p. 501–41.

    Google Scholar 

  3. Falconi M, Eriksson B, Kaltsas G, et al. ENETS consensus guidelines update for the management of patients with functional pancreatic neuroendocrine tumors and non-functional pancreatic neuroendocrine tumors. Neuroendocrinology. 2016;103:153–71.

    Article  CAS  PubMed  Google Scholar 

  4. Pavel M, O’Toole D, Costa F, et al. 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;103:172–85.

    Article  CAS  PubMed  Google Scholar 

  5. Jensen RT, Niederle B, Mitry E, et al. Gastrinoma (duodenal and pancreatic). Neuroendocrinology. 2006;84:173–82.

    Article  CAS  PubMed  Google Scholar 

  6. Jensen RT, Cadiot G, Brandi ML, et al. ENETS consensus guidelines for the management of patients with digestive neuroendocrine neoplasms: functional pancreatic endocrine tumor syndromes. Neuroendocrinology. 2012;95:98–119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Nieman LK. Cushing’s syndrome: update on signs, symptoms and biochemical screening. Eur J Endocrinol. 2015;173:M33–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Ito T, Igarashi H, Jensen RT. Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances. Best Pract Res Clin Gastroenterol. 2012;26:737–53.

    Article  PubMed  PubMed Central  Google Scholar 

  9. De Baere T, Deschamps F, Tselikas L, et al. GEP-NETS update: interventional radiology: role in the treatment of liver metastases from GEP-NETs. Eur J Endocrinol. 2015;172:R151–66.

    Article  PubMed  CAS  Google Scholar 

  10. Gupta S. Intra-arterial liver-directed therapies for neuroendocrine hepatic metastases. Semin Intervent Radiol. 2013;30:28–38.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kennedy AS. Hepatic-directed therapies in patients with neuroendocrine tumors. Hematol Oncol Clin North Am. 2016;30:193–207.

    Article  PubMed  Google Scholar 

  12. Del Prete M, Fiore F, Modica R, et al. Hepatic arterial embolization in patients with neuroendocrine tumors. J Exp Clin Cancer Res. 2014;33:43.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Kennedy A, Bester L, Salem R, et al. Role of hepatic intra-arterial therapies in metastatic neuroendocrine tumours (NET): guidelines from the NET-Liver-Metastases Consensus Conference. HPB (Oxford). 2015;17:29–37.

    Article  Google Scholar 

  14. Yang TX, Chua TC, Morris DL. Radioembolization and chemoembolization for unresectable neuroendocrine liver metastases - a systematic review. Surg Oncol. 2012;21:299–308.

    Article  PubMed  Google Scholar 

  15. Grozinsky-Glasberg S, Kaltsas G, Kaltsatou M, et al. Hepatic intra-arterial therapies in metastatic neuroendocrine tumors: lessons from clinical practice. Endocrine. 2018;60(3):499–509.

    Article  CAS  PubMed  Google Scholar 

  16. Chamberlain RS, Canes D, Brown KT, et al. Hepatic neuroendocrine metastases: does intervention alter outcomes? J Am Coll Surg. 2000;190:432–45.

    Article  CAS  PubMed  Google Scholar 

  17. Clift AK, Frilling A. Management of patients with hepatic metastases from neuroendocrine tumors. Ann Saudi Med. 2014;34:279–90.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Norton JA, Warren RS, Kelly MG, et al. Aggressive surgery for metastatic liver neuro- endocrine tumors. Surgery. 2003;134:1057–63.

    Article  PubMed  Google Scholar 

  19. Sarmiento JM, Heywood G, Rubin J, et al. Surgical treatment of neuroendocrine metastases to the liver: a plea for resection to increase survival. J Am Coll Surg. 2003;197:29–37.

    Article  PubMed  Google Scholar 

  20. Kianmanesh R, Sauvanet A, Hentic O, et al. Two-step surgery for synchronous bilobar liver metastases from digestive endocrine tumors: a safe approach for radical resection. Ann Surg. 2008;247:659–65.

    Article  PubMed  Google Scholar 

  21. Ito T, Igarashi H, Jensen RT. Therapy of metastatic pancreatic neuroendocrine tumors (pNETs): recent insights and advances. J Gastroenterol. 2012;47:941–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Fiore F, Del Prete M, Franco R, et al. Transarterial embolization (TAE) is equally effective and slightly safer than transarterial chemoembolization (TACE) to manage liver metastases in neuroendocrine tumors. Endocrine. 2014;47:177–82.

    Article  CAS  PubMed  Google Scholar 

  23. Dewhirst MW, Viglianti BL, Lora-Michiels M, et al. Basic principles of thermal dosimetry and thermal thresholds for tissue damage from hyperthermia. Int J Hyperth. 2003;3:267–94.

    Article  Google Scholar 

  24. Ronot M, Cuccioli F, Burgio MD, et al. Neuroendocrine liver metastases: vascular patterns on triple-phase MDCT are indicative of primary tumor location. Eur J Radiol. 2017;89:156–62.

    Article  PubMed  Google Scholar 

  25. Clouse ME, Perry L, Stuart K, et al. Hepatic arterial chemoembolization for metastatic neuroendocrine tumors. Digestion. 1994;55(Suppl. S3):92–7.

    Article  PubMed  Google Scholar 

  26. Frilling A, Clift AK. Therapeutic strategies for neuroendocrine liver metastases. Cancer. 2015;121:1172–86.

    Article  CAS  PubMed  Google Scholar 

  27. Fohlen A, Tasu JP, Kobeiter H, et al. Transarterial chemoembolization (tace) in the management of hepatocellular carcinoma: results of a French national survey on current practices. Diagn Interv Imaging. 2018;99:527–35.

    Article  CAS  PubMed  Google Scholar 

  28. Lee KH, Liapi E, Vossen JA, et al. Distribution of iron oxide-containing Embosphere particles after transcatheter arterial embolization in an animal model of liver cancer: evaluation with MR imaging and implication for therapy. J Vasc Interv Radiol. 2008;19(10):1490–6.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Dreher MR, Sharma KV, Woods DL, et al. Radiopaque drug-eluting beads for transcatheter embolotherapy: experimental study of drug penetration and coverage in swine. J Vasc Interv Radiol. 2012;23(2):257–64.

    Article  PubMed  Google Scholar 

  30. Biolato M, Marrone G, Racco S, et al. Transarterial chemoembolization (TACE) for unresectable HCC: a new life begins? Eur Rev Med Pharmacol Sci. 2010;14:356–62.

    CAS  PubMed  Google Scholar 

  31. Zhang S, Huang C, Li Z, et al. Comparison of pharmacokinetics and drug release in tissues after transarterial chemoembolization with doxorubicin using diverse lipiodol emulsions and CalliSpheres Beads in rabbit livers. Drug Deliv. 2017;24(1):1011–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  32. Varela M, Real MI, Burrel M, et al. Chemoembolization of hepatocellular carcinoma with drug eluting beads: efficacy and doxorubicin pharmacokinetics. J Hepatol. 2007;46(3):474–81.

    Article  CAS  PubMed  Google Scholar 

  33. Bloomston M, Al-Saif O, Klemanski D, et al. Hepatic artery chemoembolization in 122 patients with metastatic carcinoid tumor: lessons learned. J Gastrointest Surg. 2007;11:264–71.

    Article  PubMed  Google Scholar 

  34. Kyriacou A, Mansoor W, Lawrance J, et al. Intractable hypoglycaemia in a patient with advanced carcinoid syndrome successfully treated with hepatic embolization. Hormones (Athens). 2015;15:118–21.

    Article  Google Scholar 

  35. Maiza JC, Vezzosi D, Grunenwald S, et al. Treatment with somatostatin analogs and chemoembolization of liver metastases for severe hypoglycemia in malignant insulinomas. J Endocrinol Investig. 2011;34:e253–8.

    CAS  Google Scholar 

  36. Moscetti L, Saltarelli R, Giuliani R, et al. Intra-arterial liver chemotherapy and hormone therapy in malignant insulinoma: case report and review of the literature. Tumori. 2000;86:475–9.

    Article  CAS  PubMed  Google Scholar 

  37. Muro S, Nasu J, Harada R, et al. Prompt resolution of hypoglycemia by hepatic transarterial embolization for malignant insulinoma with multiple liver metastases. Acta Med Okayama. 2014;68:303–6.

    PubMed  Google Scholar 

  38. Pericleous M, Caplin ME, Tsochatzis E, et al. Hepatic artery embolization in advanced neuroendocrine tumors: efficacy and long-term outcomes. Asia Pac J Clin Oncol. 2016;12:61–9.

    Article  PubMed  Google Scholar 

  39. Yarmohammadi H, Erinjeri JP, Brown KT. Embolization of metastatic neuroendocrine tumor resulting in clinical manifestations of syndrome of inappropriate secretion of antidiuretic hormone. J Vasc Interv Radiol. 2015;26:533–7.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Boudreaux JP, Klimstra DS, Hassan MM, et al. North American neuroendocrine tumor society (NANETS). The NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well- differentiated neuroendocrine tumors of the jejunum, ileum, appendix, and cecum. Pancreas. 2010;39:753–66.

    Article  PubMed  Google Scholar 

  41. Kulke MH, Anthony LB, Bushnell DL, et al. NANETS treatment guidelines: well-differentiated neuroendocrine tumors of the stomach and pancreas. Pancreas. 2010;39:735–52.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Kulke MH, Shah MH, Benson AB 3rd, et al. Neuroendocrine tumors, version 1.2015. J Natl Compr Cancer Netw. 2015;13:78–108.

    Article  CAS  Google Scholar 

  43. Pavel M, Baudin E, Couvelard A, et al. Barcelona Consensus Conference participants. ENETS Consensus Guidelines for the management of patients with liver and other distant metastases from neuroendocrine neoplasms of foregut, midgut, hindgut, and unknown primary. Neuroendocrinology. 2012;95:157–76.

    Article  CAS  PubMed  Google Scholar 

  44. Maire F, Lombard-Bohas C, O’Toole D, et al. Hepatic arterial embolization versus chemoembolization in the treatment of liver metastases from well-differentiated midgut endocrine tumors: a prospective randomized study. Neuroendocrinology. 2012;96:294–300.

    Article  CAS  PubMed  Google Scholar 

  45. Gupta S, Johnson MM, Murthy R, et al. Hepatic arterial embolization and chemoembolization for the treatment of patients with metastatic neuroendocrine tumors: variables affecting response rates and survival. Cancer. 2005;104:1590–602.

    Article  PubMed  Google Scholar 

  46. Ruutiainen AT, Soulen MC, Tuite CM, et al. Chemoembolization and bland embolization of neuroendocrine tumor metastases to the liver. J Vasc Interv Radiol. 2007;18:847–55.

    Article  PubMed  Google Scholar 

  47. Bhagat N, Reyes DK, Lin M, Kamel I, et al. Phase II study of chemoembolization with drug-eluting beads in patients with hepatic neuroendocrine metastases: high incidence of biliary injury. Cardiovasc Intervent Radiol. 2013;36:449–59.

    Article  PubMed  Google Scholar 

  48. Guiu B, Deschamps F, Aho S, et al. Liver/biliary injuries following chemoembolisation of endocrine tumours and hepatocellular carcinoma: lipiodol vs. drug-eluting beads. J Hepatol. 2012;56:609–17.

    Article  CAS  PubMed  Google Scholar 

  49. Kennedy A, Nutting C, Coldwell D, et al. Pathologic response and microdosimetry of 90Y-microspheres in man: review of four explanted whole livers. Int J Radiat Oncol Biol Phys. 2004;60:1552–63.

    Article  CAS  PubMed  Google Scholar 

  50. Campbell A, Bailey I, Burton M. Tumour dosimetry in human liver following hepatic 90Y-microsphere therapy. Phys Med Biol. 2001;46:487–98.

    Article  CAS  PubMed  Google Scholar 

  51. Lau WY, Leung WT, Ho S, et al. Treatment of inoperable hepatocellular carcinoma with intrahepatic arterial yttrium-90microspheres: a phase I and II study. Br J Cancer. 1994;70:994–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Frilling A, Clift AK, Braat AJAT, Alsafi A, Wasan HS, et al. Radioembolisation with 90y microspheres for neuroendocrine liver metastases: an institutional case series, systematic review and meta-analysis. HPB. 2019;21:773–83.

    Article  PubMed  Google Scholar 

  53. Paprottka PM, Hoffmann RT, Alexander H, Sommer WH, Raessler F, Trumm RG, et al. Radioembolization of symptomatic, unresectable neuroendocrine hepatic metastases using yttrium-90 microspheres. Cardiovasc Intervent Radiol. 2012;35:334–42.

    Article  PubMed  Google Scholar 

  54. Cramer B, Xing M, Kimt HS. Prospective longitudinal quality of life assessment in patients with neuroendocrine tumor liver metastases treated with 90y radioembolization. Clin Nucl Med. 2016;41:e493–7.

    Article  PubMed  Google Scholar 

  55. Kalinowski M, Dressler M, König A, El-Sheik M, Rinke A, Höffken H, Gress TM, Arnold R, Klose KJ, Wagner HJ. Selective internal radiotherapy with Yttrium-90 microspheres for hepatic metastatic neuroendocrine tumors: a prospective single center study. Digestion. 2009;79(3):137–42.

    Article  PubMed  Google Scholar 

  56. Egger ME, Armstrong E, Martin RC 2nd, Scoggins CR, Philips P, Shah M, Konda B, Dillhoff M, Pawlik TM, Cloyd JM. Transarterial chemoembolization vs radioembolization for neuroendocrine liver metastases: a multi-institutional analysis. J Am Coll Surg. 2020;230(4):363–70.

    Article  PubMed  Google Scholar 

  57. Do Minh D, Chapiro J, Gorodetski B, Huang Q, Liu C, Smolka S, Savic LJ, Wainstejn D, Lin M, Schlachter T, Gebauer B, Geschwind JF. Intra-arterial therapy of neuroendocrine tumour liver metastases: comparing conventional TACE, drug-eluting beads TACE and yttrium-90 radioembolisation as treatment options using a propensity score analysis model. Eur Radiol. 2017;27(12):4995–5005.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Zuckerman DA, Kennard RF, Roy A, Parikh PJ, Weiner AA. Outcomes and toxicity following Yttrium-90 radioembolization for hepatic metastases from neuroendocrine tumors-a single-institution experience. J Gastrointest Oncol. 2019;10(1):118–27.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Memon K, Lewandowski RJ, Mulcahy MF, Riaz A, Ryu RK, Sato KT, Gupta R, et al. Radioembolization for neuroendocrine liver metastases: safety, imaging, and long-term outcomes. Int J Radiat Oncol Biol Phys. 2012;83(3):887–94.

    Article  PubMed  Google Scholar 

  60. Braat A, Kappadath SC, Ahmadzadehfar H, Stothers CL, Frilling A, et al. Radioembolization with (90)y resin microspheres of neuroendocrine liver metastases: international multicenter study on efficacy and toxicity. Cardiovasc Intervent Radiol. 2019;42:413–25.

    Article  CAS  PubMed  Google Scholar 

  61. Barbier C, Garske-Román U, Sandström M, Nyman R, Granberg D. Selective internal radiation therapy in patients with progressive neuroendocrine liver metastases. Eur J Nucl Med Mol Imaging. 2016;43:1425–31.

    Article  CAS  PubMed  Google Scholar 

  62. Chansanti O, Jahangiri Y, Matsui Y, Adachi A. Tumor dose response in yttrium-90 resin microsphere embolization for neuroendocrine liver metastases: a tumor-specific analysis with dose estimation using SPECT-CT. J Vasc Interv Radiol. 2017;28:1528–35.

    Article  PubMed  Google Scholar 

  63. Braat MNGJA, van Erpecumb KJ, Zonnenberga BA, et al. Radioembolization-induced liver disease: a systematic review. Eur J Gastroenterol Hepatol. 2017;29:144–52.

    Article  CAS  PubMed  Google Scholar 

  64. Sangro B, Gil-Alzugaray B, Rodriguez J, et al. Liver disease induced by radioembolization of liver tumors: description and possible risk factors. Cancer. 2008;112:1538–46.

    Article  PubMed  Google Scholar 

  65. Memon K, Lewandowski RJ, Kulik L, et al. Radioembolization for primary and metastatic liver cancer. Semin Radiat Oncol. 2011;21:294–302.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Seidensticker R, Seidensticker M, Damm R, et al. Hepatic toxicity after radioembolization of the liver using 90y-microspheres: sequential lobar versus whole liver approach. Cardiovasc Intervent Radiol. 2012;35:1109–18.

    Article  PubMed  Google Scholar 

  67. Yu-Kai S, Mackey RV, Riaz A, et al. Long-term hepatotoxicity of yttrium-90 radioembolization as treatment of metastatic neuroendocrine tumor to the liver. J Vasc Interv Radiol. 2017;28:1520–6.

    Article  Google Scholar 

  68. Yao JC, Hassan M, Phan A, et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26:3063–72.

    Article  PubMed  Google Scholar 

  69. Tan MC, Jarnagin WR. Surgical management of non-colorectal hepatic metastasis. J Surg Oncol. 2014;109:8–13.

    Article  PubMed  Google Scholar 

  70. Scott AT, Breheny PJ, Keck KJ, et al. Effective cytoreduction can be achieved in patients with numerous neuroendocrine tumor liver metastases (NETLMs). Surgery. 2019;165:166–75.

    Article  PubMed  Google Scholar 

  71. Osborne DA, Zervos EE, Strosberg J, et al. Improved outcome with cytoreduction versus embolization for symptomatic hepatic metastases of carcinoid and neuroendocrine tumors. Ann Surg Oncol. 2006;13:572–81.

    Article  PubMed  Google Scholar 

  72. Frilling A, Modlin IM, Kidd M, et al. Recommendations for management of patients with neuroendocrine liver metastases. Lancet Oncol. 2014;15:e8–21.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  74. Glazer ES, Tseng JF, Al-Refaie W, et al. Long-term survival after surgical management of neuroendocrine hepatic metastases. HPB (Oxford). 2010;12:427–33.

    Article  Google Scholar 

  75. Mayo SC, de Jong MC, Pulitano C, et al. Surgical management of hepatic neuroendocrine tumor metastasis: results from an international multi-institutional analysis. Ann Surg Oncol. 2010;17:3129–36.

    Article  PubMed  Google Scholar 

  76. Chen MH, Wei Y, Yan K, et al. Treatment strategy to optimize radiofrequency ablation for liver malignancies. J Vasc Interv Radiol. 2006;17:671–83.

    Article  PubMed  Google Scholar 

  77. Lee JM, Han JK, Kim HC, et al. Multiple-electrode radiofrequency ablation of in vivo porcine liver: comparative studies of consecutive monopolar, switching monopolar versus multipolar modes. Investig Radiol. 2007;42:676–83.

    Article  Google Scholar 

  78. Solbiati L, Livraghi T, Goldberg SN, et al. Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology. 2001;221:159–66.

    Article  CAS  PubMed  Google Scholar 

  79. Sánchez Y, Anvari A, Samir AE, et al. Navigational guidance and ablation planning tools for interventional radiology. Curr Probl Diagn Radiol. 2017;46(3):225–33.

    Article  PubMed  Google Scholar 

  80. Covey AM, Sofocleous CT. Radiofrequency ablation as a treatment strategy for liver metastases from breast cancer. Semin Intervent Radiol. 2008;25(4):406–12.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Takahashi H, Akyuz M, Aksoy E, et al. Local recurrence after laparoscopic radiofrequency ablation of malignant liver tumors: results of a contemporary series. J Surg Oncol. 2017;115(7):830–4.

    Article  PubMed  Google Scholar 

  82. Goldberg SN, Hahn PF, Tanabe KK, et al. Percutaneous radiofrequency tissue ablation: does perfusion-mediated tissue cooling limit coagulation necrosis? J Vasc Interv Radiol. 1998;9:101–11.

    Article  CAS  PubMed  Google Scholar 

  83. Dupuy DE, Goldberg SN. Image-guided radiofrequency tumor ablation: challenges and opportunities–part II. J Vasc Interv Radiol. 2001;12:1135–48.

    Article  CAS  PubMed  Google Scholar 

  84. Harring TR, Nguyen NT, Goss JA, et al. Treatment of liver metastases in patients with neuroendocrine tumors: a comprehensive review. Int J Hepatol. 2011;2011:1–11.

    Article  Google Scholar 

  85. Eriksson J, Stalberg P, Nilsson A, et al. Surgery and radiofrequency ablation for treatment of liver metastases from midgut and foregut carcinoids and endocrine pancreatic tumors. World J Surg. 2008;32:930–8.

    Article  PubMed  Google Scholar 

  86. Mazzaglia PJ, Berber E, Milas M, et al. Laparoscopic radiofrequency ablation of neuroendocrine liver metastases: a 10-year experience evaluating predictors of survival. Surgery. 2007;142:10–9.

    Article  PubMed  Google Scholar 

  87. Karabulut K, Akyildiz HY, Lance C, et al. Multimodality treatment of neuroendocrine liver metastases. Surgery. 2011;150:316–25.

    Article  PubMed  Google Scholar 

  88. Gillams A, Cassoni A, Conway G, et al. Radiofrequency ablation of neuroendocrine liver metastases: the Middlesex experience. Abdom Imaging. 2005;30:435–41.

    Article  CAS  PubMed  Google Scholar 

  89. Kose E, Kahramangil B, Aydin H, et al. Outcomes of laparoscopic tumor ablation for neuroendocrine liver metastases: a 20-year experience. Surg Endosc. 2020;34(1):249–56.

    Article  PubMed  Google Scholar 

  90. Lubner MG, Brace CL, Hinshaw JL, et al. Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol. 2010;21:S192–203.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Perrodin SF, Renzulli MM, Maurer MH, et al. Can microwave ablation be an alternative to resection for the treatment of neuroendocrine liver metastases? Endocr Pract. 2020;26(4):378–87.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Franco Orsi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Orsi, F., Bonomo, G. (2021). Locoregional Therapies of NEN. In: Beretta, G., Berruti, A., Bombardieri, E., Fazio, N., Goletti, O. (eds) Neuroendocrine Neoplasia Management. Springer, Cham. https://doi.org/10.1007/978-3-030-72830-4_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-72830-4_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-72829-8

  • Online ISBN: 978-3-030-72830-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics