Evidence map›Paper›PMID 39676650›Full record

Observational studyAnnals of surgery2026

Trends in the Management and Outcomes of Neuroendocrine Liver Metastases: A 3-decade, Multicenter Observational Cohort Study.

Andrea Frilling, Ashley K Clift, Daniel Kaemmerer, Kira C Steinkraus, Joerg Schrader, Stefan Wolter, Panagiotis Drymousis, Marc-Olaf Liedke, Merten Hommann, Nagy Habib and 4 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Neuroendocrine liver metastasis.Hepatobiliary surgery and nutrition · 2025
    Article
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Andrea FrillingDepartment of Surgery and Cancer, Imperial College London, London, UK.
Ashley K CliftDepartment of Surgery and Cancer, Imperial College London, London, UK.
Daniel KaemmererDepartment of General and Visceral Surgery, Zentralklinik Bad Berka, Bad Berka, Germany.
Kira C SteinkrausDepartment of General and Visceral Surgery, University Hospital Ulm, Ulm, Germany.
Joerg SchraderDepartment of Medicine, University Hospital Hamburg Eppendorf, Hamburg, Germany.
Stefan WolterDepartment of General and Visceral Surgery, Regio Hospital Pinneberg, Pinneberg, Germany.
Panagiotis DrymousisDepartment of Surgery, Ealing Hospital, London North West University Healthcare NHS Trust, London, UK.
Marc-Olaf LiedkeDepartment of General, Visceral and Vascular Surgery, Westkuestenklinikum Heide, Heide, Germany.
Merten HommannDepartment of General and Visceral Surgery, Zentralklinik Bad Berka, Bad Berka, Germany.
Nagy HabibDepartment of Surgery and Cancer, Imperial College London, London, UK.
Richard P BaumDepartment of Nuclear Medicine, CURANOSTICUM, Wiesbaden, Germany.
Harpreet WasanDepartment of Surgery and Cancer, Imperial College London, London, UK.
Irvin M ModlinDepartment of Surgery, Yale University School of Medicine, New Haven, CT.
Jakob R IzbickiDepartment of General, Visceral and Thoracic Surgery, University Hospital Hamburg Eppendorf, Hamburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo describe the evolution of management strategies for neuroendocrine liver metastases (NE LM) and trends in patient outcomes over the preceding 3 decades.

backgroundLiver metastases are common in neuroendocrine neoplasms and impair prognosis. A broad therapeutic armamentarium has evolved over recent decades, but there remains uncertainty regarding optimal treatment selection and sequencing.

methodsRetrospective cohort study pooling data from 4 specialist centers of excellence in the United Kingdom and Germany for individuals diagnosed with neuroendocrine liver metastases between January 1, 1990, and December 31, 2020. We explored trends in theranostic strategies over 3 decades and quantified overall survival (cohort, and by decade-defined temporal periods).

resultsWe identified 551 individuals with NE LM with a median age at diagnosis of 59.1 years; 453 (82.2%) had synchronous metastases, and 402 (73.0%) underwent multimodal therapy. In all centers, somatostatin receptor-based PET/CT and MRI were the preferred imaging techniques. There were significant trends in the use of somatostatin analogs and peptide receptor radionuclide therapy, but the number of surgical resections remained stable. Overall survival (OS) at 5 and 10 years was 77.5% and 58.1%, respectively. Across the 3 time periods, 5-year OS significantly improved-period I: 45.2%, period II: 66.0%, and period III: 75.7%. Ten-year OS showed overlapping confidence intervals for period I (23.5%) and period II (18.3%) but doubled in period III (55.5%). On multivariable analysis, the use of multimodal therapy strategies was significantly associated with improved overall survival (HR=0.59, 95% CI: 0.40-0.88, P =0.009).

conclusionsImproved imaging modalities and modifications in specific therapies as components of multimodal treatment concepts are concordant with significantly improved survival outcomes in NELM over 30 years. The use of multimodal therapy improved overall survival in patients with NE LM. Future studies should determine optimal treatment selection and sequencing and the role of novel biomarkers to guide these.

Indexed as

Liver NeoplasmsNeuroendocrine TumorsAgedCombined Modality TherapyFemaleGermanyHumansMaleMiddle AgedRetrospective StudiesSurvival RateUnited Kingdomliver metastasesneuroendocrineoutcomes

Identifiers

PMID39676650

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.