Liver resection for ovarian cancer liver metastases as part of cytoreductive surgery is safe and may bring survival benefit.

Nicolae Bacalbasa,Simona Dima,Leonard David,Irinel Popescu,Vladislav Brasoveanu,Raluca Purnichescu-Purtan,Irina Balescu

doi:10.1186/s12957-015-0652-0

Abstract

BackgroundThe aim of this study was to evaluate whether hepatic resections of ovarian cancer liver metastases provide a benefit in terms of survival as part of primary, secondary, tertiary, and even quaternary cytoreductive surgery.MethodsData of patients submitted to surgery for ovarian cancer liver metastases at Fundeni Clinical Institute between January 2002 and April 2014 were retrospectively reviewed. Liver lesions were classified according to their origin in parenchymal and peritoneal lesions.ResultsA total of 31 patients were identified: 11 of them underwent liver resection as part of primary cytoreduction, 15 at secondary cytoreduction, 3 at tertiary cytoreduction, and 2 at the time of quaternary cytoreduction. The survival of patients with primary cytoreduction including liver resection was significantly higher compared with that of patients with secondary cytoreductive surgery including liver resection (15.63 versus 6.63 months, log-rank p = 0.057, 90 % CI). The median survival of patients with hepatectomy for liver metastases from peritoneal seeding was higher than that of patients with hepatectomy for liver metastases from hematogenous origin (16.08 versus 12.66 months, log-rank p = 0.523).ConclusionsHepatectomy in ovarian cancer liver metastases is a safe and effective procedure; however, a benefit in terms of survival in favor of peritoneal seeding has been systematically observed.

Highlights

The aim of this study was to evaluate whether hepatic resections of ovarian cancer liver metastases provide a benefit in terms of survival as part of primary, secondary, tertiary, and even quaternary cytoreductive surgery
Since up to 50 % of patients who die of ovarian cancer have liver involvement at autopsy [7], and some are up front diagnosed with liver metastases, one could question a possible benefit for liver resection especially for a disease in which the mainstay of treatment is maximal cytoreductive surgery
Patients submitted to liver resection for ovarian cancer liver metastases at the moment of primary, secondary, tertiary, and quaternary cytoreduction were considered eligible for the study

Summary

Introduction

The aim of this study was to evaluate whether hepatic resections of ovarian cancer liver metastases provide a benefit in terms of survival as part of primary, secondary, tertiary, and even quaternary cytoreductive surgery. Since up to 50 % of patients who die of ovarian cancer have liver involvement at autopsy [7], and some are up front diagnosed with liver metastases, one could question a possible benefit for liver resection especially for a disease in which the mainstay of treatment is maximal cytoreductive surgery. Even though literature regarding the benefit of liver resection for non-colorectal non-neuroendocrine liver metastasis is increasingly being published, there are few studies regarding liver metastases from gynecologic primaries [7,8,9,10,11,12,13,14,15,16,17,18]

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