Hospital procedure volume and hospital teaching status do not influence operative mortality or long-term survival for rectal cancer in a large general population: An outcomes study

Abstract

The indications for the resection of noncolorectal/nonneuroendocrine hepatic metastases (NCNNE) have evolved as the safety of hepatic resection has increased. The prognostic features of NCNNE treated surgically were reviewed in order to better define the indications for resection. Methods: A retrospective review of patients undergoing liver resection for NCNNE between 1978 and 1997. Results: Thirty patients were identified. The mean age was 57 years with a median follow up of 18 months. Primary tumor sites included GI adenocarcinoma (bowel n=3, unknown n=2, pancreatic n=2, esophageal n=l), and other (renal cell n=5, testicular n=l, ovarian n=l, sarcoma n=6, adrenal n=3, melanoma n=3, thyroid n=2, and breast n=l). All patients were operated upon for cure. Synchronous metastases were treated in 9 patients. There was no operative mortality. Overall survival is shown in Figure 1. Survival was better in patients with non-GI origin metastases (Figure 2, p=0.04). Long term survivors were seen only in patients with non GI origin metastases. Neither the extent of resection (segmental n=l 1, lobe n---14, extended n=5) nor the presence of synchronous metastases was predictive of outcome.