Invited Critique |

Metastatic Neuroendocrine Hepatic Tumors—Invited Critique

Michael J. Demeure, MD
Arch Surg. 2006;141(10):1005. doi:10.1001/archsurg.141.10.1005.
Text Size: A A A
Published online


The article by Musunuru et al is a retrospective series from a well-respected institution with extensive experience in the treatment of endocrine tumors. Musunuru et al1 examine their experience with 48 patients, seen from 1996 through 2004, with metastatic neuroendocrine tumors confined to the liver. Patients were treated by medical (or no) therapy, hepatic artery embolization, chemoembolization, or surgical resection. In all, 36 patients had carcinoid tumors and 12 had islet cell cancers. The authors examined their experience in light of the lack of existing level I data in the published literature and contribute their findings to reports from other institutions including the Mayo Clinic,1,2 University of California, san Francisco,3 and M. D. Anderson Cancer Center.4 Although this article is a valuable addition to the literature, this study has 2 major limitations. There was a lack of prospective treatment guidelines that could result in a lack of uniformity in the treatment of patients by the various surgeons at this single institution. I am also disappointed that there was no prospective surveillance protocol to monitor the timing and pattern of recurrence.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles