Surgical strategy for neuroendocrine liver metastases

IntroductionThere are no established strategies for the surgical management of neuroendocrine liver metastases. Surgical treatment options include liver resection, liver transplantation and debulking hepatectomy. Other liver‐directed therapies include local ablation and transarterial embolization.AimIn the present review, we discuss the outcomes of the different surgical treatment modalities for neuroendocrine liver metastases.Patients and methodsA review of the published literature on the surgical management of neuroendocrine liver metastases was undertaken.ResultsLiver resection is the curative treatment of choice for patients with grade 1 or 2 liver metastases without concurrent extra‐hepatic disease. Liver transplantation is another potentially curative therapy. Debulking hepatectomy might be indicated for symptomatic neuroendocrine liver disease, whereas liver ‐directed local ablative and trans‐arterial treatments should be considered for patients not suitable for liver resection or transplantation.ConclusionsHepatectomy and liver transplanatation should be offered to patients with resectable neuroendocrine liver metastases in the absence of extrahepatic metastases.