Article

Long-term results of liver resection for non-colorectal, non-neuroendocrine metastases.

Department of Hepatobiliary Surgery, Basingstoke and North Hampshire Foundation Trust, Basingstoke, United Kingdom.
Annals of Surgical Oncology (impact factor: 4.17). 01/2008; 15(1):207-18. DOI:10.1245/s10434-007-9649-4 pp.207-18
Source: PubMed

ABSTRACT The safety and efficacy of liver resection for colorectal and neuroendocrine liver metastases is well established. However, there is lack of consensus regarding long-term effectiveness of hepatic resection for non-colorectal, non-neuroendocrine (NCNN) liver metastases.
A review of prospectively collected data of patients undergoing hepatic resection for NCNN liver metastases at two tertiary referral centres in the UK and Australia was undertaken. Survival analysis was used to evaluate the clinical, demographic and operative factors associated with long-term survival.
A total of 114 hepatic resections in 102 patients were performed between 1986 and 2006. Postoperative mortality and morbidity was 0.8% and 21.1%, respectively. At 3 and 5 years overall survival was 56.1% and 38.5%, whereas disease-free survival was 37.2% and 26.5%, respectively. On multivariate analysis, factors associated with poor overall survival were diameter of liver metastasis [<5 cm versus >5 cm: hazard ratio (HR) = 2.83, p = 0.001] and the presence of extrahepatic nodal disease (HR = 3.58, p = 0.001). The type of tumor, the presence of distant extra-hepatic metastases, tumor-free interval, number and distribution of metastases did not effect long-term survival.
These results of the present study suggest that liver resection is an effective management option in selected patients with NCNN metastases confined to the liver.

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    Article: Liver resection for noncolorectal and nonneuroendocrine metastases: results of a study on 56 patients at a single institution.
    Vittorio Bresadola, Anna Rossetto, Gian Luigi Adani, Umberto Baccarani, Dario Lorenzin, Alessandro Favero, Fabrizio Bresadola
    [show abstract] [hide abstract]
    ABSTRACT: The usefulness of surgical treatment for hepatic metastases of noncolorectal nonneuroendocrine (NCRNNE) tumors is not yet clear due to the natural history of these tumors, their frequent systemic dissemination and their histological heterogeneity. The aim of this study was to evaluate the long-term outcome of patients who underwent liver resection for NCRNNE metastases. For this purpose we retrospectively analyzed 202 patients who underwent liver resection for metastasis between January 1989 and December 2006 at the Department of Surgery of the University Hospital of Udine. Fifty-six patients underwent liver resection because of NCRNNE metastases. The preoperative assessment was based on hepatic ultrasonography and CT scan; PET was used in a few patients. All patients had intraoperative liver ultrasonography to evaluate the lesions and to define the resection. Gender, age, primary tumor site (gastrointestinal or nongastrointestinal), synchronous or metachronous metastasis, unilobar or bilobar localization, number and diameter of the lesion(s), type of resection, margin status, positive lymph nodes in the hepatoduodenal ligament, and time between surgery and diagnosis of liver metastases were evaluated as possible prognostic factors for survival. Univariate analysis showed that the location of the primary tumor and the disease-free interval since the treatment of the primary tumor were positive predictive factors for longer survival. Multivariate analysis showed that the only independent significant factor was gastrointestinal versus nongastrointestinal origin. Demographic data, the synchronous or metachronous appearance of metastases, their unilobar or bilobar location, number and size, the type of resection, the resection margin status and the involvement of lymph nodes did not prove to be prognostic factors.
    Tumori 97(3):316-22. · 0.86 Impact Factor
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Keywords

114 hepatic resections
 
5 years
 
disease-free survival
 
distant extra-hepatic metastases
 
effective management option
 
extrahepatic nodal disease
 
hepatic resection
 
HR
 
liver metastasis [<5 cm
 
liver resection
 
long-term effectiveness
 
long-term survival
 
NCNN
 
NCNN liver metastases
 
NCNN metastases
 
neuroendocrine liver metastases
 
patients undergoing hepatic resection
 
Postoperative mortality
 
Survival analysis
 
tumor-free interval