Liver metastases from soft tissue sarcomas

Hafner, Gordon H.; Rao, Uma; Karakousis, Constantine P.

doi:10.1002/jso.2930580104

Cited by 22 publications

(9 citation statements)

References 18 publications

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“…In a recent review on hepatic resection of noncolorectal, nonendocrine tumors, Schwartz [20] concluded that the prognosis was distinctly poorer than in patients having liver resection for colorectal metastases but that resection should be performed for liver metastases from hypernephroma or Wilms tumor and perhaps for adrenocortical carcinoma. Hepatic resection of other noncolorectal, nonendocrine tumors has only rarely resulted in longterm survival [1][2][3][4][5][6][7][8][12][13][14][15][16][17][18][19][20], although a few recent reports have suggested that rare patients with hepatic metastases from soft tissue sarcoma [21,22], melanoma [23] or metachronously from gastric carcinoma [24] may benefit from resection.…”

Section: Discussionmentioning

confidence: 99%

Liver resection of noncolorectal secondaries

et al. 1998

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Section: Discussionmentioning

confidence: 99%

Liver resection of noncolorectal secondaries

et al. 1998

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“…As for most tumors, resection should be reserved for those in whom R0 resection is the goal at the time of surgery. • Chen et al [ [17]. Repeat resection of hepatic metastases was discussed earlier.…”

Section: Pharmacologic Treatmentmentioning

confidence: 97%

“…Hepatic metastases from STS are most often treated with nonsurgical therapy. The indications and outcome data for resection of liver metastases from STS have been derived from series reporting on resection of noncolorectal non-neuroendocrine liver metastases [10][11][12][13], from case reports [14,15], and from the few series [16][17][18][19][20][21]22••] that have reported specifically on the treatment of STS metastases to the liver.…”

Section: Treatment Of Hepatic Metastatic Diseasementioning

confidence: 99%

Metastasectomy for limited metastases from soft tissue sarcoma

Abdalla

Pisters

2002

Curr. Treat. Options in Oncol.

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The development of metastatic soft tissue sarcoma (American Joint Committee on Cancer stage IV) is associated with a poor prognosis. Surgical resection of isolated solitary or multiple metastases is the only curative treatment; all other forms of treatment are considered palliative. As with all surgical procedures, patient selection is important to maximize the clinical benefit of metastasectomy and to minimize the risk for treatment-related morbidity. Over the past decade, nonresectional ablative approaches have been developed to manage visceral metastatic disease. These ablative procedures include cryosurgery, radiofrequency tumor ablation, and alcohol injection. All such procedures are considered investigational; outcome should be compared to that achievable with traditional surgical metastasectomy. The optimal sequence of treatments and role for perioperative (combined with metastasectomy) chemotherapy are unknown. Given the potential curative nature of metastasectomy, all patients with metastatic soft tissue sarcoma should be evaluated for the possibility of surgical resection. Patients with good performance status who have radiographically resectable disease should be considered for metastasectomy.

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“…Synchronous liver involvement has been reported in 1% to 20% of patients with soft tissue sarcoma depending on the primary origin. 27,28 Metastases to the liver as a component of recurrence have been reported in as high as 86% of patients, however. [28][29][30] Liver involvement by soft tissue sarcoma usually results from primary visceral and retroperitoneal tumors rather than from extremity sarcomas.…”

Section: Sarcomamentioning

confidence: 99%

Radiofrequency Ablation of Carcinoid and Sarcoma Liver Metastases

Parikh¹,

Fornage²,

Curley³

et al. 2004

Radiofrequency Ablation for Cancer

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The relative safety of radiofrequency ablation for malignant tumors has increased the indications for its use in the therapy of metastatic disease. Although tumor debulking has been considered inappropriate oncologic therapy in the past due to the associated complications and lack of clinical benefit, with safer techniques we are now able to determine if destroying most of the tumor mass in the liver can translate into improved palliation or even improved survival in patients with diseases considered inoperable in the past. Radiofrequency Ablation (RFA) of Hepatic Metastases from Carcinoid TumorsCarcinoid tumors belong to the family of neuroendocrine tumors and are the most frequent gastrointestinal endocrine tumors (55%). They are still relatively rare, representing only 10% of small bowel tumors and 2% of all gastrointestinal malignancies. 1,2 The overall incidence is reported to be between 1 and 2/100,000 per year. 3-5 Carcinoid tumors have traditionally been classified according to their embryologic derivation. Foregut carcinoids comprise 20% of all carcinoid tumors and include thymic, lung, gastric, and duodenal tumors. Hindgut carcinoids constitute 15% of all carcinoid tumors and commonly originate from the colon 107 7 or rectum. Midgut carcinoids arise from the small bowel, appendix, and proximal colon, and make up 40% of carcinoid tumors. 4,5 The most common gastrointestinal site of origin is the appendix, followed by the small intestine and rectum. Carcinoid tumors produce a variety of biologically active hormones depending on their site of origin. The best characterized of these substances is serotonin, but they have also been found to produce and secrete adrenocorticotropic hormone (ACTH), gastrin, histamine, dopamine, substance P, chromogranin A, neurotensin, prostaglandins, and others. 4,5 Although generally indolent in their growth and progression, carcinoid tumors are the most frequent neuroendocrine tumors to metastasize to the liver. 6 In fact a majority of patients present with disseminated disease and involvement of the liver at the time of diagnosis. These patients usually have primary and metastatic carcinoid tumors that remain asymptomatic until their hepatic tumor burden overtakes the liver's ability to metabolize active hormones produced by these tumors, resulting in carcinoid syndrome. This severe endocrinopathy is characterized by flushing, diarrhea, cardiac valvular damage, bronchoconstriction, and asthma. 2,4,5,7 The incidence of carcinoid syndrome, caused by metastases to the liver is about 0.5/100,000, and most are associated with primary tumors of the small intestine. 8 Patients in whom metastatic disease is suspected should be evaluated by abdominal imaging, including ultrasound, computed tomography (CT), CT-angioportography, magnetic resonance imaging (MRI), or octreotide scintigraphy to rule out liver metastases. 1 Liver function tests are usually unreliable for screening for metastasis, as they are only elevated when there is a large burden of tumor in the liver. 5 Carcinoid met...

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Liver metastases from soft tissue sarcomas

Cited by 22 publications

References 18 publications

Liver resection of noncolorectal secondaries

Liver resection of noncolorectal secondaries

Metastasectomy for limited metastases from soft tissue sarcoma

Radiofrequency Ablation of Carcinoid and Sarcoma Liver Metastases

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