A.B. Benson

Local-regional therapy for metastatic liver tumors

The presence of metastatic liver disease in a patient with a primary gastrointestinal malignancy is an ominous finding and presents a complex challenge to the oncologist. By definition, these patients have advanced stage disease and thus carry an extremely poor long-term prognosis. Treatment strategies directed at local control of the primary tumor become more palliative in nature, and any chance to significantly alter the natural history of the disease is predicated upon effective hepatic-directed therapy. The following chapter will provide an overview on surgical and nonsurgical hepatic-directed therapy for metastatic liver disease.

Treatment Patterns of Lung Neuroendocrine Tumors (NETs)

• The high proportion of chemotherapy use and low proportion receiving second-line treatment seems consistent with NCCN SCLC (rather than NET) treatment guidelines. For typical lung NETs, the NET guidelines mention chemotherapy (Category 3*) only if other treatment options are not feasible (although for atypical disease and low grade NETs with high tumor burden, chemotherapy may initially be used). 1,4-7