Liver resection (LR) is considered the treatment of choice for resectable neuroendocrine liver metastases (NELM), while liver transplantation (LT) is currently reserved for highly selected unresectable patients. We retrospectively analyzed data from consecutive patients undergoing either curative resection or transplantation for liver-only NELM meeting Milan criteria at a single center between 1984 and 2019. Patients who fit Milan criteria were 48 in the transplantation group and 56 in the resection group. After a median follow-up of 158 months for the transplantation group and 126 for the resection group, the 10-year survival rate was 93% for transplantation and 75% for resection (p = .007). The 10-year disease-free survival rate was 52% for transplantation and 18% for resection (p < .001). Transplantation was associated with improved survival at univariate analysis. The median disease-free interval between surgery and recurrence was 78 months for transplantation vs. 24 months for resection (p < .001). The transplantation group had more multisite recurrences (12/25, 48% vs. 5/42, 12% in the resection group, p = .001), while most recurrences in the resection group were intra-hepatic (37/42, 88%, versus 2/25, 8% in the transplantation group). In conclusion, LT was associated with improved survival outcomes in NELM meeting the Milan criteria compared with LR.

中文翻译：

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符合米兰标准的神经内分泌肝转移切除与移植的长期结果

肝切除术 (LR) 被认为是可切除的神经内分泌肝转移 (NELM) 的首选治疗方法，而肝移植 (LT) 目前仅用于高度选择的不可切除患者。我们回顾性分析了 1984 年至 2019 年间在单个中心接受根治性切除术或移植治疗仅肝脏 NELM 且符合米兰标准的连续患者的数据。符合米兰标准的患者为移植组 48 例和切除组 56 例。在移植组和切除组的中位随访时间分别为 158 个月和 126 个月后，移植组的 10 年生存率为 93%，切除组为 75% ( p  = .007)。移植的 10 年无病生存率为 52%，切除为 18%（p <.001）。在单变量分析中，移植与提高的生存率相关。移植手术和复发之间的中位无病间隔时间为 78 个月，而切除手术为 24 个月 ( p  < .001)。移植组有更多的多部位复发（12/25，48% vs. 5/42，切除组 12%，p  = .001），而切除组的大多数复发是肝内复发（37/42，88 %，而移植组为 2/25，8%）。总之，与 LR 相比，LT 与符合米兰标准的 NELM 中的生存结果改善相关。