Hepatic resection of non-colorectal and non-neuroendocrine liver metastases – Survival benefit for patients with non-gastrointestinal primary cancers – A case-controlled study

Abstract

a b s t r a c tPurpose: Whereas resection of colorectal liver metastases is gold standard, there is an ongoing debate on benefit of resection of non-colorectal (NCRC) and non-neuroendocrine (NNEC) liver metastases. Methods: The potential survival benefit of patients undergoing resection of NCRC or NNEC liver metastases was investigated. Data from a prospectively maintained database were reviewed over a 7-year period. KaplaneMeier method was used for the evaluation of outcome following resection. Results: 101 patients underwent 116 surgical procedures for synchronous and metachronous NCRC or NNEC liver metastases with a morbidity of 23% and a mortality of w1%. 11 patients underwent repeated liver resection procedures. Overall 5-year survival after liver resection was 30% depending on primary tumour site. Median survival was significantly increased after resection of hepatic metastases from nongastrointestinal primaries compared to gastrointestinal primaries. Resection of hepatic metastases from non-gastrointestinal primaries resulted in significantly increased median survival compared to exploration only. Patients with hepatic metastases from gastrointestinal primaries did not benefit from hepatic surgery. Conclusion: Hepatic resection for liver metastases from NCRC or NNEC cancers is a save treatment procedure. However, the decision to perform surgery should depend on the primary cancer. Especially patients with liver metastases from non-gastrointestinal primaries profit from hepatic surgery.

The benefits of liver resection for non-colorectal, non-neuroendocrine liver metastases: a systematic review

“…Our data are consistent with most series that report poor long-term survival after liver resection [6]. Similarly, Slotta et al found no benefit to resection for gastric, pancreatic, and esophageal liver metastasis, with an approximately 20 % 5-year survival period [38]. Although some subsets, such as small bowel and duodenal cancers, have surprisingly good survival, these data need to be interpreted with great caution because small sample size is likely to consist of highly selected group of patients.…”

“…Despite the limitations of these data, it is generally seen that outcomes are poor for patients with non-colorectal gastrointestinal primaries [32,37]. This is further highlighted by a recent case-controlled study that found no difference between observation and resection for this group [38]. The authors did, however, report an advantage to resection versus observation for patients with non-gastrointestinal primaries.…”

Distant Liver Metastases as a Major Factor Influencing Survival in Patients with Colorectal Cancer

“…9 This in turn improved the prognosis of patients with end-stage colorectal cancer. 10 In the group of patients with HMD the cases with single liver lesions were predominant. This trend is due to early detection of metastatic process as a result of the progress of diagnostic imaging methods.…”

Management of Liver Oligometastatic Esophageal Cancer: Overview and Critical Analysis of the Different Loco-Regional Treatments

“…In this subset of patients, the median OS was 17 months while 1-year and 3-year DFS were 42% and 35%, respectively. Slotta et al [25] reported a mean survival of 12.5 months in patients treated by metastasectomy, underlining the striking impact of hepatic surgery in the prognosis of liver OEC disease.…”

“…We found some studies regarding synchronous disease [14,15,[23][24][25]. Van Daele et al [14] reported an overall survival (OS) and disease-free survival (DFS) of 50% and 33% at a median follow-up of 22 months after surgery, respectively.…”