This protocol covers Zollinger-Ellison syndrome in the specific setting of metastatic gastrinoma with liver metastases — a clinically distinct presentation that calls for targeted surgical and oncologic evaluation.
The patient has metastatic gastrinoma with liver metastases. Hepatic involvement in this setting carries prognostic significance: there is evidence that resection of liver metastases improves survival, making careful assessment of the extent and resectability of hepatic disease a central step in management.
Surgical resection of liver involvement may be considered when preoperative imaging demonstrates that sufficient tumor removal is feasible — the full protocol specifies the exact resectability threshold, candidacy criteria, and procedural guidance.
There is evidence that resection of liver metastases improves survival, although it is difficult to conclude for certain that the demonstrated differences in survival are dependent on surgical treatment, and not the extent of disease itself.
The current recommendation is to attempt to perform liver resection when at least 90% of the tumor appears to be able to be removed on preoperative imaging studies.
DOI: 10.1016/j.suc.2009.06.018
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