Benefit of Surgical Cytoreduction for Patients with Small Intestinal Neuroendocrine Tumors Metastatic to the Liver and Peritoneum
Complete cytoreduction can significantly improve survival and relieve symptoms in patients with small intestinal neuroendocrine tumors metastatic to the liver and peritoneum. Despite initial controversies, achieving complete cytoreduction yielded comparable outcomes in patients with isolated liver metastases and those with liver and peritoneal metastases. Aggressive surgical cytoreduction should be considered even in the presence of peritoneal metastases for favorable patient outcomes.
In patients with gastric cancer and positive peritoneal lavage cytology or localized peritoneal metastasis, upfront chemotherapy followed by surgery yields better outcomes than surgery followed by chemotherapy.
Secondary cytoreductive surgery with hyperthermic intraperitoneal chemotherapy improves survival for select patients with recurrent colorectal cancer peritoneal metastases.
