胃肠胰神经内分泌肿瘤肝转移治疗策略

Modern strategy for the management of gastroenteropancreatic neuroendocrine neoplasm liver metastases

胃肠胰神经内分泌肿瘤(gastroenteropancreatic neuroendocrine neoplasms,GEP-NENs)是具有较强异质性的一大类肿瘤的总称,其生物学行为差异较大。影响肿瘤预后的主要因素包括组织学分级、TNM分期以及原发肿瘤部位等,其中肝转移是决定病人预后的重要因素。应当在充分评估肿瘤生物学行为的基础上,权衡延长生存时间、改善生活质量、降低治疗风险等诸多因素,整体规划多学科治疗手段,并依疗效、治疗的毒副反应等随时调整治疗策略。

Gastroenteropancreatic neuroendocrine neoplasms （GEP-NENs） are rare, generally indolent tumors with heterogeneous biological behavior. Grade, TNM staging, primary tumor site are main factors that influence the prognosis. Among them, liver metastases hold a critical position. Well, moderate and poorly differentiated tumors have different potential of liver metastases, which should be treated with different strategies. Before any therapeutic procedure is taken, a comprehensive evaluation of tumor＇ s bio-behavior is mandatory. Even for a well planed MDT strategy, adjustments based on the balancing between risks and benefits, overall survival time and quality of life are often needed.