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The symptoms associated with hepatic metastatses from a pancreatic neuroendocrine tumor (NET) can be ameliorated through surgical debulking, suggests Rodney F. Pommier, MD. Moreover, an improvement in long-term outcomes can be achieved by an approximate 90% tumor debulking regardless of the margins, unlike other metastatic tumors. In fact, Pommier notes, many metastatic lesions within the liver can be enucleated without causing higher rates of recurrence.
Outside of surgical options, a variety of other treatment approaches can be utilized for patients with liver metastases, including chemoembolization, radioembolization, and ablation. However, these techniques should be considered secondary to surgery, since they may preclude a successful liver operation, Pommier advises. In general, embolization for liver metastases should be reserved for patients with extensive disease that cannot be treated by surgical debulking.