Margin status is a predictor of long-term survival following resection of non-colorectal, non-net liver metastases

Abstract

Aims: The role of resectional surgery for colorectal liver metastases is well defined with improved 5-year survival rates. Non-colorectal, non-neuroendocrine liver metastases (NCNNLM) are not uncommonly encountered but the role of surgery is not yet clearly defined. This study is aimed to assess the immediate and long-term outcomes following liver resection for NCNNLM. Methods: Patients who underwent liver resection for NCNNLM between 2004 and 2014 were included from a prospectively maintained database at a tertiary referral centre. 90-day mortality, post-operative morbidity, disease-free (DFS) and overall survival (OS) were assessed. Univariable analyses were performed to identify predictors of survival. All analyses were performed using IBM SPSS 19 (IBM Corp. Armonk, NY), with p < 0.05 being statistically significant. Results: A total of 44 patients underwent 54 liver resections. Median age group was 54 years (range, 32–77 years). Metastases from breast (25%) and renal (15%) primaries were most commonly encountered. 19.3% were synchronous metastases. 90-day mortality and post-operative morbidity were 2% and 11% respectively. OS and DFS for NCNNLM at 1- year were 90% and 60% and at 5-years were 57% and 25% respectively. OS for breast and renal cancer at 1 year were 93% and 67% and at 5-years were 49% and 51% respectively. Positive resection margin has a significant influence on the OS (p = 0.018) on univariate analysis. Conclusions: Resection of liver metastases should be considered for NCNNLM as the survival rates are satisfactory. R0 resection remains an important determinant of overall survival.