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Multimodal therapy with aggressive hepatectomy, everolimus, and octreotide for metastatic pancreatic neuroendocrine neoplasm enables 10-year survival

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Abstract

The presence of neuroendocrine liver metastases is one of the poorest prognostic factors in patients with pancreatic neuroendocrine neoplasms, and surgical resection of neuroendocrine liver metastases is the only curable treatment. A 38-year-old man had a pancreatic neuroendocrine neoplasm with synchronous multiple liver metastases, and two surgeries and continuous everolimus and octreotide achieved R0 resection. However, multiple neuroendocrine liver metastases developed twice after more than 5 years of recurrence-free survival. Aggressive repeat hepatectomy was performed and he has survived for more than 10 years after the initial surgery. This report highlights that patients with pancreatic neuroendocrine neoplasms have a potential risk of recurrence even after 5 years of recurrence-free survival. In addition, combined aggressive hepatectomy and continuous medication can contribute dramatically to long-term survival even for late-stage recurrence of liver metastases.

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Abbreviations

pNEN(s):

Pancreatic neuroendocrine neoplasm(s)

NELM:

Neuroendocrine liver metastases

OS:

Overall survival

CT:

Computed tomography

HCC:

Hepatocellular carcinoma

S6:

Segment 6

S7:

Segment 7

MRI:

Magnetic resonance imaging

FDG-PET:

Fluorodeoxyglucose-positron emission tomography

PTR:

Primary tumor resection

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Acknowledgements

We thank Jane Charbonneau, DVM, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan

    Shinsei Yumoto, Shigeki Nakagawa, Hiromitsu Hayashi, Daisuke Ogawa, Yuta Shiraishi, Hiroki Sato, Takashi Matsumoto, Katsunori Imai, Yo-ichi Yamashita & Hideo Baba

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  1. Shinsei Yumoto
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  2. Shigeki Nakagawa
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  3. Hiromitsu Hayashi
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  5. Yuta Shiraishi
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  6. Hiroki Sato
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Contributions

SY described and designed the article. SN and HH and edited the article. Hideo Baba supervised the editing of the manuscript. Other remaining co-authors collected the data and discussed the content of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hideo Baba.

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The authors declare that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee and with the Helsinki Declaration. This study procedure was approved by the Institutional Review Board of Kumamoto University Hospital.

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Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

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Yumoto, S., Nakagawa, S., Hayashi, H. et al. Multimodal therapy with aggressive hepatectomy, everolimus, and octreotide for metastatic pancreatic neuroendocrine neoplasm enables 10-year survival. Clin J Gastroenterol 15, 1136–1144 (2022). https://doi.org/10.1007/s12328-022-01689-3

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  • DOI: https://doi.org/10.1007/s12328-022-01689-3

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