Liver transplantation for metastatic neuroendocrine tumors: Outcomes and prognostic variables

Linda S. Sher, David M. Levi, Julie S. Wecsler, Mary Lo, Lydia M. Petrovic, Susan Groshen, Lingyun Ji, Teresa Diago Uso, A. Joseph Tector, Ann S. Hamilton, J. Wallis Marsh, Myron E. Schwartz

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background Patient selection for liver transplantation for metastatic neuroendocrine tumors remains a topic of debate. There is no established MELD exception, making it difficult to obtain donor organs. Methods A multicenter database was created assessing outcomes for liver and multivisceral transplantation for metastatic neuroendocrine tumors and identifying prognostic factors for survival. Demographic, transplant, primary tumor site and management, pathology, recurrent disease and survival data were collected and analyzed. Survival probabilities were calculated using the Kaplan-Meier method. Results Analysis included 85 patients who underwent liver transplantation November 1988-January 2012 at 28 centers. One, three, and five-year patient survival rates were 83%, 60%, and 52%, respectively; 40 of 85 patients died, with 20 of 40 deaths due to recurrent disease. In univariate analyses, the following were predictors of poor prognosis: large vessel invasion (P<0.001), extent of extrahepatic resection at liver transplant (P=0.007), and tumor differentiation (P=0.003). In multivariable analysis, predictors of poor overall survival included large vessel invasion (P=0.001), and extent of extrahepatic resection at liver transplant (P=0.015). Conclusion In the absence of poor prognostic factors, metastatic neuroendocrine tumor is an acceptable indication for liver transplantation. Identification of favorable prognostic factors should allow assignment of a MELD exception similar to hepatocellular carcinoma. J. Surg. Oncol. 2015 111:125-132.

Original languageEnglish
Pages (from-to)125-132
Number of pages8
JournalJournal of Surgical Oncology
Volume112
Issue number2
DOIs
StatePublished - Aug 1 2015

Fingerprint

Neuroendocrine Tumors
Liver Transplantation
Survival
Transplants
Liver
Patient Selection
Hepatocellular Carcinoma
Neoplasms
Survival Rate
Demography
Tissue Donors
Databases
Pathology

Keywords

  • liver transplantation
  • neuroendocrine tumor
  • prognostic indicators

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Sher, L. S., Levi, D. M., Wecsler, J. S., Lo, M., Petrovic, L. M., Groshen, S., ... Schwartz, M. E. (2015). Liver transplantation for metastatic neuroendocrine tumors: Outcomes and prognostic variables. Journal of Surgical Oncology, 112(2), 125-132. https://doi.org/10.1002/jso.23973

Liver transplantation for metastatic neuroendocrine tumors : Outcomes and prognostic variables. / Sher, Linda S.; Levi, David M.; Wecsler, Julie S.; Lo, Mary; Petrovic, Lydia M.; Groshen, Susan; Ji, Lingyun; Uso, Teresa Diago; Tector, A. Joseph; Hamilton, Ann S.; Marsh, J. Wallis; Schwartz, Myron E.

In: Journal of Surgical Oncology, Vol. 112, No. 2, 01.08.2015, p. 125-132.

Research output: Contribution to journalArticle

Sher, LS, Levi, DM, Wecsler, JS, Lo, M, Petrovic, LM, Groshen, S, Ji, L, Uso, TD, Tector, AJ, Hamilton, AS, Marsh, JW & Schwartz, ME 2015, 'Liver transplantation for metastatic neuroendocrine tumors: Outcomes and prognostic variables', Journal of Surgical Oncology, vol. 112, no. 2, pp. 125-132. https://doi.org/10.1002/jso.23973
Sher, Linda S. ; Levi, David M. ; Wecsler, Julie S. ; Lo, Mary ; Petrovic, Lydia M. ; Groshen, Susan ; Ji, Lingyun ; Uso, Teresa Diago ; Tector, A. Joseph ; Hamilton, Ann S. ; Marsh, J. Wallis ; Schwartz, Myron E. / Liver transplantation for metastatic neuroendocrine tumors : Outcomes and prognostic variables. In: Journal of Surgical Oncology. 2015 ; Vol. 112, No. 2. pp. 125-132.
@article{0137e0291389449a92f762273f265632,
title = "Liver transplantation for metastatic neuroendocrine tumors: Outcomes and prognostic variables",
abstract = "Background Patient selection for liver transplantation for metastatic neuroendocrine tumors remains a topic of debate. There is no established MELD exception, making it difficult to obtain donor organs. Methods A multicenter database was created assessing outcomes for liver and multivisceral transplantation for metastatic neuroendocrine tumors and identifying prognostic factors for survival. Demographic, transplant, primary tumor site and management, pathology, recurrent disease and survival data were collected and analyzed. Survival probabilities were calculated using the Kaplan-Meier method. Results Analysis included 85 patients who underwent liver transplantation November 1988-January 2012 at 28 centers. One, three, and five-year patient survival rates were 83{\%}, 60{\%}, and 52{\%}, respectively; 40 of 85 patients died, with 20 of 40 deaths due to recurrent disease. In univariate analyses, the following were predictors of poor prognosis: large vessel invasion (P<0.001), extent of extrahepatic resection at liver transplant (P=0.007), and tumor differentiation (P=0.003). In multivariable analysis, predictors of poor overall survival included large vessel invasion (P=0.001), and extent of extrahepatic resection at liver transplant (P=0.015). Conclusion In the absence of poor prognostic factors, metastatic neuroendocrine tumor is an acceptable indication for liver transplantation. Identification of favorable prognostic factors should allow assignment of a MELD exception similar to hepatocellular carcinoma. J. Surg. Oncol. 2015 111:125-132.",
keywords = "liver transplantation, neuroendocrine tumor, prognostic indicators",
author = "Sher, {Linda S.} and Levi, {David M.} and Wecsler, {Julie S.} and Mary Lo and Petrovic, {Lydia M.} and Susan Groshen and Lingyun Ji and Uso, {Teresa Diago} and Tector, {A. Joseph} and Hamilton, {Ann S.} and Marsh, {J. Wallis} and Schwartz, {Myron E.}",
year = "2015",
month = "8",
day = "1",
doi = "10.1002/jso.23973",
language = "English",
volume = "112",
pages = "125--132",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "2",

}

TY - JOUR

T1 - Liver transplantation for metastatic neuroendocrine tumors

T2 - Outcomes and prognostic variables

AU - Sher, Linda S.

AU - Levi, David M.

AU - Wecsler, Julie S.

AU - Lo, Mary

AU - Petrovic, Lydia M.

AU - Groshen, Susan

AU - Ji, Lingyun

AU - Uso, Teresa Diago

AU - Tector, A. Joseph

AU - Hamilton, Ann S.

AU - Marsh, J. Wallis

AU - Schwartz, Myron E.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background Patient selection for liver transplantation for metastatic neuroendocrine tumors remains a topic of debate. There is no established MELD exception, making it difficult to obtain donor organs. Methods A multicenter database was created assessing outcomes for liver and multivisceral transplantation for metastatic neuroendocrine tumors and identifying prognostic factors for survival. Demographic, transplant, primary tumor site and management, pathology, recurrent disease and survival data were collected and analyzed. Survival probabilities were calculated using the Kaplan-Meier method. Results Analysis included 85 patients who underwent liver transplantation November 1988-January 2012 at 28 centers. One, three, and five-year patient survival rates were 83%, 60%, and 52%, respectively; 40 of 85 patients died, with 20 of 40 deaths due to recurrent disease. In univariate analyses, the following were predictors of poor prognosis: large vessel invasion (P<0.001), extent of extrahepatic resection at liver transplant (P=0.007), and tumor differentiation (P=0.003). In multivariable analysis, predictors of poor overall survival included large vessel invasion (P=0.001), and extent of extrahepatic resection at liver transplant (P=0.015). Conclusion In the absence of poor prognostic factors, metastatic neuroendocrine tumor is an acceptable indication for liver transplantation. Identification of favorable prognostic factors should allow assignment of a MELD exception similar to hepatocellular carcinoma. J. Surg. Oncol. 2015 111:125-132.

AB - Background Patient selection for liver transplantation for metastatic neuroendocrine tumors remains a topic of debate. There is no established MELD exception, making it difficult to obtain donor organs. Methods A multicenter database was created assessing outcomes for liver and multivisceral transplantation for metastatic neuroendocrine tumors and identifying prognostic factors for survival. Demographic, transplant, primary tumor site and management, pathology, recurrent disease and survival data were collected and analyzed. Survival probabilities were calculated using the Kaplan-Meier method. Results Analysis included 85 patients who underwent liver transplantation November 1988-January 2012 at 28 centers. One, three, and five-year patient survival rates were 83%, 60%, and 52%, respectively; 40 of 85 patients died, with 20 of 40 deaths due to recurrent disease. In univariate analyses, the following were predictors of poor prognosis: large vessel invasion (P<0.001), extent of extrahepatic resection at liver transplant (P=0.007), and tumor differentiation (P=0.003). In multivariable analysis, predictors of poor overall survival included large vessel invasion (P=0.001), and extent of extrahepatic resection at liver transplant (P=0.015). Conclusion In the absence of poor prognostic factors, metastatic neuroendocrine tumor is an acceptable indication for liver transplantation. Identification of favorable prognostic factors should allow assignment of a MELD exception similar to hepatocellular carcinoma. J. Surg. Oncol. 2015 111:125-132.

KW - liver transplantation

KW - neuroendocrine tumor

KW - prognostic indicators

UR - http://www.scopus.com/inward/record.url?scp=84940028274&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940028274&partnerID=8YFLogxK

U2 - 10.1002/jso.23973

DO - 10.1002/jso.23973

M3 - Article

C2 - 26171686

AN - SCOPUS:84940028274

VL - 112

SP - 125

EP - 132

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 2

ER -