Neuroendocrine tumors with hepatic metastases: A review of evolving treatment options

Once considered exceptionally rare, neuroendocrine tumors (NET) are increasingly common and therefore of growing relevance to both clinicians and researchers. Most patients with such tumors present with symptoms, and, of those, 90% have secondary liver involvement. In the recent past, individuals with metastatic liver disease were offered little in the way of therapy, or hope. Over the last few years, this fatalist approach has been rapidly replaced with a variety of new strategies for both systemic and loco-regional treatment options. Both sequential and parallel combined therapies, newly available drugs and a multi-disciplinary approach to patient management are all contributing to a revolution in the care and outcomes for this population. In this review, the reader will be oriented to the relevant statistics, nomenclature and diagnostic modalities for this confusing set of diseases. Most important is an update on the rapidly expanding treatment options available for optimizing care among patients with liver involvement.