Liver transplantation for patients with neuroendocrine liver metastases (NELM) provides durable overall survival (OS) at 10 years, according to research presented at the 2026 NANETS Multidisciplinary NET Medical Symposium.
This retrospective analysis included data from 47 patients treated at Mayo Clinics in Florida, Minnesota, and Arizona from 1998 to 2026. Investigators evaluated baseline characteristics such as tumor biology (Ki-67, grade), timing of diagnosis and transplant, and patterns of recurrence. OS and disease-free survival (DFS) from transplant were the primary outcomes.
The median age of the patients was 48 years. The most common primary tumor sites were the pancreas (n=23) and small bowel (n=22).
The median OS was approximately 9 years, and the median DFS was approximately 4 years. At 10 years, the OS rate was 44.3% and the DFS rate was 20.1%.
“At 10 years, roughly 1 in 5 patients was alive without recurrence,” said study presenter Joseph Kim, MD, of the Mayo Clinic in Jacksonville, Florida. “The takeaway message … is transplant binds durable survival, but often, usually, it’s not a cure, and recurrence happens for most patients.”
The investigators attempted to identify factors that predicted the best patient outcomes. The most predictive factor was tumor replacement greater than 50%, in which the tumor is replacing more than half the liver. In multivariate analyses, the hazard ratios for this factor were 3.03 for OS and 3.27 for DFS.
Dr Kim noted that 31 patients (66%) experienced post-transplantation recurrence, with a median time to recurrence of 2.3 years. However, recurrence can occur later, so follow-up must continue beyond that point, possibly for the rest of the patient’s life.
“But recurrence is not the end of the story. Median survival after recurrence was 4.2 years; 39% were, in fact, actually alive at 5 years after recurrence,” he said. “So, how should we counsel patients on recurrence? We should tell them that about two-thirds of the patients will eventually recur, and recurrence is not the end of the story, with post-transplant treatment like somatostatin and [peptide receptor radionuclide therapy] having meaningful benefit.”
Disclosures: No disclosures were provided.
