Hepatic resection of non-colorectal or non-neuroendocrine liver metastases is a useful therapy strategy to improve survival

Abstract

Resection of liver metastases from colorectal cancer is the gold standard treatment option with low peri-operative mortality and a 5-year survival of ˜40%. However, there is an ongoing debate on benefit and long-term survival of hepatic resection of non-colorectal (NCRC) and non-neuroendocrine (NNEC) liver metastases. Design: Therefore, in the present study we investigated the potential survival benefit of patients undergoing resection of NCRC or NNEC liver metastases, enabling even repeated resections in recurrent disease. Data from a prospectively maintained database of patients undergoing hepatic resection for liver metastases were reviewed over a 7-year period. Outcome Measures: For the evaluation of outcome following resection the Kaplan-Meier method was used. Correlations were calculated between clinicopathological variables. Results: Between March 2001 and December 2007, 101 patients (female 56.4%, male 43.6%) underwent 116 liver resections for synchronous (26.7%) and metachronous (73.3%) NCRC or NNEC liver metastases: 14 major resections (≥3 anatomical segments), 78 minor liver resections, and 24 explorations only. 11 patients underwent repeated liver resection procedures. Overall 1-, 3- and 5-year survival after liver resection was 66%, 43% and 30% respectively, which was dependent of manifestation site of primary tumor, i.e. gastrointestinal or other localization. Patients with repeated liver resections had a 5-year survival of 60%. Although 5-year survival after major hepatectomy was not significantly reduced, large dissection areas were associated with a significant reduction of the 5-year survival rate (30%). Conclusion: Patients with metastasized NCRC or NNEC cancers are suitable candidates for hepatectomy and repeated liver resections. Accordingly, extent of resection should be as spare as possible.