Surgical treatment of liver metastases from non-colorectal non-neuroendocrine carcinomas

Astrid Bauschke,Jörg Pertschy,Herry Helfritzsch,Merten Homman,Utz Settmacher,Hubert Göbel,Thomas Manger,Annelore Altendorf-Hofmann

doi:10.1007/s00432-021-03631-5

Abstract

IntroductionIn the literature, results after surgical treatment of non-colorectal non-neuroendocrine liver metastases (NCNNLM) are reported that are often inferior to those from colorectal liver metastases. The selection of patients with favorable tumor biology is currently still a matter of discussion.Materials/methodsThe retrospective data analysis was based on data that were collected for the multicenter study “Role of surgical treatment for non-colorectal liver metastases” in county Thuringia.ResultsFor the study, 637 patients were included from 1995 to 2018. 5 and 10-year survival of R0 resected patients were 33% and 19%, respectively. In the multi-variate analysis of the entire group, sex, timing, disease-free interval, number of metastases, R-classification as well as lymph node status of the primary lesion showed an independent statistical influence on the 5-year survival. In the group of R0 resected patients, disease-free interval, number of metastases and lymph node status of the primary lesion influenced the 5-year survival in the multi-variate analysis. In kidney malignancies, R-classification, timing and number of liver metastases were statistically significant in the multi-variate analysis of the 5-year survival, in mamma carcinomas only the R-classification.ConclusionThe Adam score identifies some risk factors which influence prognosis in most but not in all tumor entities. For kidney cancer and breast cancer it can be simplified.

Highlights

In the literature, results after surgical treatment of non-colorectal non-neuroendocrine liver metastases (NCNNLM) are reported that are often inferior to those from colorectal liver metastases
Morphology, and 11 patient characteristics, metastases, primary tumor lesion, liver metastases, surgical procedure, and individual hospital experience. 86% of the patients (546) underwent treatment in the nine transregional hospitals, 14% (91) in regional hospitals. 15 hospitals treated less than 40 patients, four hospitals between 40 and 100 patients, and the university hospital treated 213 patients
We further investigated the prognostic factors for longterm survival in adenocarcinomas, gastrointestinal carcinomas, breast cancers and kidney carcinomas

Summary

Introduction

Results after surgical treatment of non-colorectal non-neuroendocrine liver metastases (NCNNLM) are reported that are often inferior to those from colorectal liver metastases. In the multi-variate analysis of the entire group, sex, timing, disease-free interval, number of metastases, R-classification as well as lymph node status of the primary lesion showed an independent statistical influence on the 5-year survival. In the group of R0 resected patients, disease-free interval, number of metastases and lymph node status of the primary lesion influenced the 5-year survival in the multi-variate analysis. R-classification, timing and number of liver metastases were statistically significant in the multi-variate analysis of the 5-year survival, in mamma carcinomas only the R-classification. The effect of surgical therapy of non-colorectal non-neuroendocrine carcinomas is still under debate. Due to small incidence of liver metastases suitable for complete resection, only a few studies can give guidelines or recommendations for systemic or local therapy. Often patients are presented to the surgeon when systemic therapies lead to progressive disease

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