Outcomes of liver resections for neuroendocrine tumor liver metastases in carcinoid heart disease

Carcinoid heart disease (CHD) is associated with advanced neuroendocrine tumor liver metastases (NETLM) and may preclude surgical cytoreduction. We assessed perioperative and long-term outcomes of hepatectomy in patients with CHD. We retrospectively analyzed 311 patients undergoing cytoreductive hepatectomy for intestinal NETLM: non-functional (n = 163), carcinoid syndrome (CS) without CHD (n = 110), and CHD (n = 38), including patients undergoing pre-hepatectomy valve replacement. CHD patients more frequently had >10 liver metastases (78%) and larger lesions (median 9.5 cm) and required major hepatectomy more often (58%). Major morbidity was higher in CHD (up to 47%), yet 90-day mortality remained low (≤4%). Median overall survival after hepatectomy was comparable across groups (12.5 vs. 9.1 vs. 11.4 years; p = .19), including matched analyses. With optimal cardiac management, cytoreductive hepatectomy in CHD is feasible and provides long-term survival comparable to patients without CHD.

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Publication Details

Journal
Journal of Neuroendocrinology
Published
2026-06-30
DOI
https://doi.org/10.1111/jne.70226
Primary Topic
Neuroendocrine Tumor Research Advances
Type
article
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article

Outcomes of liver resections for neuroendocrine tumor liver metastases in carcinoid heart disease

Patrick P. Starlinger, M. Truty, Rory L. Smoot, Patricia A. Pellikka et al.
Journal of Neuroendocrinology
Neuroendocrine Tumor Research Advances
article

Outcomes of liver resections for neuroendocrine tumor liver metastases in carcinoid heart disease

Patrick P. Starlinger, M. Truty, Rory L. Smoot, Patricia A. Pellikka, Juan A. Crestanello, Cornelius A. Thiels, Jonas Santol, Hallbera Gudmundsdottir, David M. Nagorney, Yawen Dong, Heidi M. Connolly, Þorvarður R. Hálfdánarson, Susanne G Warner, Michael L. Kendrick, David Pereyra, M Ammann, Hartzell V. Schaff, Vanja Podrascanin
article en

Abstract

Carcinoid heart disease (CHD) is associated with advanced neuroendocrine tumor liver metastases (NETLM) and may preclude surgical cytoreduction. We assessed perioperative and long-term outcomes of hepatectomy in patients with CHD. We retrospectively analyzed 311 patients undergoing cytoreductive hepatectomy for intestinal NETLM: non-functional (n = 163), carcinoid syndrome (CS) without CHD (n = 110), and CHD (n = 38), including patients undergoing pre-hepatectomy valve replacement. CHD patients more frequently had >10 liver metastases (78%) and larger lesions (median 9.5 cm) and required major hepatectomy more often (58%). Major morbidity was higher in CHD (up to 47%), yet 90-day mortality remained low (≤4%). Median overall survival after hepatectomy was comparable across groups (12.5 vs. 9.1 vs. 11.4 years; p = .19), including matched analyses. With optimal cardiac management, cytoreductive hepatectomy in CHD is feasible and provides long-term survival comparable to patients without CHD.

Journal of NeuroendocrinologyVol. 38(7)
Sigmund Freud Privatuniversität Wien (AT), Mayo Clinic (US), Fachhochschule Wiener Neustadt (AT), Mayo Clinic in Florida (US), Medical University of Vienna (AT)
Good health and well-being
Openalex Percentile: Top 7%
Neuroendocrine Tumor Research Advances
DOISourceOpenAlex
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