Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma.
OBJECTIVE
To define perioperative and long-term outcome and prognostic factors in patients undergoing hepatectomy for liver metastases arising from noncolorectal and nonneuroendocrine (NCNN) carcinoma.


BACKGROUND
Hepatic resection is a well-established therapy for patients with liver metastases from colorectal or neuroendocrine carcinoma. However, for patients with liver metastases from other carcinomas, the value of resection is incompletely defined and still debated.


METHODS
Between April 1981 and April 2002, 141 patients underwent hepatic resection for liver metastases from NCNN carcinoma. Patient demographics, tumor characteristics, treatment, and postoperative outcome were analyzed.


RESULTS
Thirty-day postoperative mortality was 0% and 46 of 141 (33%) patients developed postoperative complications. The median follow up was 26 months (interquartile range [IQR]) 10-49 months); the median follow up for survivors was 35 months (IQR 11-68 months). There have been 24 actual 5-year survivors so far. The actuarial 3-year relapse-free survival rate was 30% (95% confidence interval [CI], 21-39%) with a median of 17 months. The actuarial 3-year cancer-specific survival rate was 57% (95% CI, 48-67%) with a median of 42 months. Primary tumor type and length of disease-free interval from the primary tumor were significant independent prognostic factors for relapse-free and cancer-specific survival. Margin status was significant for cancer-specific survival and showed a strong trend for relapse-free survival.


CONCLUSIONS
Hepatic resection for metastases from NCNN carcinoma is safe and can offer long-term survival in selected patients. Hepatic resection should be considered if all gross disease can be removed, especially in patients with metastases from reproductive tract tumors or a disease-free interval greater than 2 years.
Weitz
Jürgen
J
Hepatobiliary Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Blumgart
Leslie H
LH
Fong
Yuman
Y
Jarnagin
William R
WR
D'Angelica
Michael
M
Harrison
Lawrence E
LE
DeMatteo
Ronald P
RP
D000306:Adrenal Cortex Neoplasms / Q000473:pathology; D018268:Adrenocortical Carcinoma / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D008297:Male; D008545:Melanoma / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000473:pathology; D016896:Treatment Outcome