title: Changes in indication and results after resection of hepatic metastases from noncolorectal primary tumors: a single-institutional review.
abstract: BACKGROUND
  The isolated occurrence of noncolorectal liver metastases is rare. The available data are inconsistent in terms of indication for surgery, treatment, and outcome, so a generally applicable therapeutic algorithm is currently lacking.
  
  
  METHODS
  A total of 162 patients underwent resection for noncolorectal liver metastases between 1978 and 2001. The patients were divided into two groups from different time periods (group 1, 1978-1989; group 2, 1990-2001) that were similar in terms of number of patients, operating surgeons, and surgical techniques used. The groups were compared, and the data were retrospectively analyzed with regard to indication, survival, and factors predictive for survival.
  
  
  RESULTS
  Resection was performed to remove liver metastases from noncolorectal gastrointestinal carcinoma (n = 50), neuroendocrine tumors (n = 12), genitourinary primary tumors (n = 11), breast carcinoma (n = 24), leiomyosarcoma (n = 15), and metastases from other primary cancers (n = 50). Extrahepatic tumor involvement was seen in 38 (23%) of the 162 cases. Sixty-two (38%) major hepatectomies and 100 (62%) minor resections were performed. In 100 (62%) of 162 patients, a curative resection (R0) could be achieved. Overall 2- and 5-year survival rates of 49% and 26%, respectively, were observed, and the median survival was 23 months. Survival was significantly longer in patients who underwent an R0 resection.
  
  
  CONCLUSIONS
  In selected patients, resection of noncolorectal liver metastases is associated with a 5-year survival rate of up to 50%. Resection of liver metastases from gastrointestinal adenocarcinomas correlates with a poor prognosis. Extrahepatic metastases may be considered a relative contraindication for liver resection.
authors.affiliation: Department of Surgery, University of Erlangen, Krankenhausstrasse,12, Erlangen, D-91054, Germany. suleyman.yedibela@chir.med.uni-erlangen.de
authors.forename: Süleyman
authors.initials: S
authors.lastname: Yedibela
authors.forename: Jonas
authors.initials: J
authors.lastname: Gohl
authors.forename: Valentina
authors.initials: V
authors.lastname: Graz
authors.forename: Mona Kathrin
authors.initials: MK
authors.lastname: Pfaffenberger
authors.forename: Susanne
authors.initials: S
authors.lastname: Merkel
authors.forename: Werner
authors.initials: W
authors.lastname: Hohenberger
authors.forename: Thomas
authors.initials: T
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology; D018579:Patient Selection; D012189:Retrospective Studies; D014565:Urogenital Neoplasms / Q000473:pathology