Resection of recurrent ovarian or fallopian tube carcinoma involving the liver.
OBJECTIVE
Patients who develop recurrent ovarian of fallopian tube carcinoma involving the liver often have disease refractory to chemotherapy and carry a poor prognosis. The impact of aggressive resection in this patient population is unclear.


METHODS
From 1/1988 to 9/2001, 24 patients with recurrent ovarian or fallopian tube carcinoma who underwent complete gross resection or optimal debulking of their hepatic metastases and disease at other sites were identified from prospective databases at a single institution.


RESULTS
The median age of patients was 53 years old, and the median interval between primary diagnosis and liver resection was 69 months. All patients had primary resection or cytoreduction and chemotherapy as part of their initial treatment. Subsequent hepatic resections included trisegmentectomy (2), lobectomy (2), segmentectomy (17), and wedge resection (3). Additional resection of disease outside the liver was performed in 18 patients (75%). Twenty-one patients (88%) had removal of all gross disease, and three patients (13%) had optimal tumor debulking to less than 1 cm. Eighteen patients recurred with sites of initial recurrence, including the abdomen and pelvis (14), spine/paraspinal region (2), lung (1), and liver (1). Overall median survival was 62 months after hepatic resection with a range of 6 to 94 months. Fourteen patients were alive at the time of last follow-up, and 10 had no evidence of disease. No significant prognostic factors for overall survival could be identified on univariate analysis.


CONCLUSIONS
In highly selected patients with recurrent ovarian or fallopian tube carcinoma involving the liver, hepatic resection along with resection of other gross disease may lengthen survival and should be considered as a treatment option.
Hepatobiliary Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
Sam S
SS
Yoon
William R
WR
Jarnagin
Yuman
Y
Fong
Ronald P
RP
DeMatteo
Richard R
RR
Barakat
Leslie H
LH
Blumgart
Dennis S
DS
Chi
D000328:Adult; D005185:Fallopian Tube Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate