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January 2012

Neuroendocrine Liver Metastasis: Transplant as Part of Multimodality Liver-Directed Therapy

Author Affiliations

Author Affiliations: Divisions of Surgical Oncology (Drs Mayo and Cameron) and Transplant Surgery (Dr Pawlik), Department of Surgery (Drs Mayo, Cameron, and Pawlik), The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Arch Surg. 2012;147(1):98-99. doi:10.1001/archsurg.147.1.98

We read with great interest the recent article by Gedaly et al1 regarding the role of liver transplantation for patients with metastatic neuroendocrine tumors. The authors used the United Network for Organ Sharing database to identify 150 patients with metastatic neuroendocrine tumors out of 87 280 patients who underwent a liver transplant during the 10-year period from 1998 to 2008. During the same period, Gedaly et al1 compared the survival of patients who underwent a transplant for neuroendocrine liver metastasis (NELM) with the survival of patients who underwent a transplant for hepatocellular carcinoma. They reported 1-, 3-, and 5-year survival rates of 81%, 65%, and 49%, respectively, for the 137 patients who underwent an isolated liver transplant for NELM. On bivariate analyses, the authors did not note a difference in survival following a transplant for patients with NELM compared with patients with hepatocellular carcinoma (P = .20). The authors concluded that a transplant for unresectable NELM disease is indicated in patients with a stable disease without disseminated metastases.

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