To evaluate the safety, short-term outcome and long-term efficacy of cytoreductive surgery for neuroendocrine tumor liver metastases (NETLM).

Clinical data of 31 patients with NETLM undergoing cytoreductive surgery in Fudan University Shanghai Cancer Center from September 2021 to April 2023 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 14 patients were male and 17 female, with a median age of 55(46,60) years. Gastrointestinal pancreas was the primary lesion site of NETLM patients (n=25, 80.6%). Patients with NETLM of G2 accounted for 81%(25/31), and 94%(29/31) of non-functional NETLM. 27 patients received preoperative medication therapy, 21 cases of preoperative transcatheter arterial embolization, and 16 cases of resection of primary lesions, respectively. The operation time, intraoperative blood loss and blood transfusion were observed. The short-term postoperative outcomes included postoperative length of hospital stay, incidence of postoperative complications and mortality rate. The long-term prognosis was progression-free survival (PFS). Kaplan-Meier survival curve was used for survival analysis.

The tumor burden of liver metastases was (40±3)%, and the maximal diameter of liver metastases was 10.0(8.5, 13.5) cm. The operation time was 168 (135,235) min. The intraoperative blood loss was 800 (300,1 000) ml, and 17 cases required blood transfusion. The length of postoperative hospital stay was 6 (5,7) d. The incidence of postoperative complications was 48%(15/31), and no perioperative death was found. Postoperatively, tumor grade was increased in 6 cases. The median PFS was 12.0 (95%CI: 6.9-17.1) months. The 6-, 12- and 18-month PFS rate was 85%, 56% and 37%, respectively.

Cytoreductive surgery is relatively safe for NETLM patients, which can obtain favorable survival benefits and provide guidance for subsequent treatment.