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Hepatic resection of noncolorectal nonneuroendocrine metastases
Author(s) -
Hemming Alan W.,
Sielaff Tim D.,
Gallinger Steven,
Cattral Mark S.,
Taylor Bryce R.,
Greig Paul D.,
Langer Bernard
Publication year - 2000
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.500060114
Subject(s) - medicine , metastasis , esophagus , gastroenterology , surgery , melanoma , adenocarcinoma , retrospective cohort study , cancer , cancer research
Because hepatic resection is generally a safe procedure, the indications for resection of noncolorectal nonneuroendocrine (NCNNE) hepatic metastases have broadened. The prognostic features of NCNNE metastases treated surgically were reviewed to define better the value of resection. A retrospective review of patients undergoing liver resection for NCNNE metastases between 1978 and 1998 was undertaken. Thirty‐seven patients were identified. Mean age was 56 years, with a median follow‐up of 22 months. Primary tumor sites were grouped into gastrointestinal (GI) adenocarcinoma (small bowel, n = 4; pancreas, n = 2; esophagus, n = 1) and other (renal cell, n = 7; sarcoma, n = 7; melanoma, n = 5; adrenal, n = 3; unknown adenocarcinoma, n = 3; thyroid, n = 2; testicular, n = 1; ovarian, n = 1; breast, n = 1). All patients underwent surgery for cure. Metastases were synchronous in 14 patients. There was no surgical mortality. Overall 5‐year survival rate was 45%. Five‐year survival rates were better for patients with non–GI‐origin metastases (60% v 0%; P = .01). Long‐term survival was seen only in patients with non–GI‐origin metastases. The extent of resection, presence of synchronous metastases, or disease‐free interval from time of original disease to presentation with liver metastases were not predictive of outcome. We conclude that patients with NCNNE hepatic metastases can undergo liver resection with an expectation of prolonged survival. However, patients with liver metastases from GI primary tumors other than the colorectum are unlikely to show extended survival.