Surgical Treatment of Primary Neuroendocrine Tumors of the Liver

ABSTRACT

PURPOSE: Primary neuroendocrine tumor (PNET) of the liver is a very rare neoplasm. This study was conducted to analyze the clinical experience of 8 hepatic PNET cases. METHODS: Four male and 4 female patients with a mean age of 50.4 +/- 9.5 years (range 37-64 years) underwent liver resection for hepatic PNET between January 1997 and December 2006. The diagnosis was confirmed histologically using light microscopy and immunohistochemistry in the absence of an alternative primary site RESULTS: Curative resection was achieved in 6 of the 8 patients, and 5 of the patients were alive and disease free after a mean follow-up period of 47.6 months. However, 3 patients died 3, 5 and 26 months after surgery due to multiple liver metastasis. A proliferative index of Ki67 appeared to indicate a significant risk factor for tumor recurrence. Additionally, recurrence occurred in 1 of the 6 patients that underwent curative resection during the follow-up period. Overall, both the 5-year recurrence rate and the 5-year survival rate were 50%. CONCLUSIONS: Active exclusion of an extrahepatic primary site is essential for diagnosis of hepatic PNET. The primary treatment for PNET is curative liver resection, and a proliferative index of Ki67 appears to be a prognostic factor for tumor recurrence.