Results of a single-center experience with resection and ablation for sarcoma metastatic to the liver.
OBJECTIVE
A subset of patients with sarcoma liver metastasis may benefit from hepatic resection and/or ablation.


METHODS
Retrospective review of prospectively collected cancer center database records.


METHODS
Sixty-six patients who underwent hepatic resection and/or open radiofrequency ablation of metastatic sarcoma between July 1, 1996, and April 30, 2005, were identified from the database. Clinicopathologic, operative, recurrence, and long-term survival data were analyzed.


RESULTS
The primary sarcoma site was the abdomen or retroperitoneum (n = 22), stomach (n = 18), small or large bowel (n = 17), pelvis (n = 4), uterus (n = 3), or other (n = 2). Tumor pathologic types included gastrointestinal stromal tumor (n = 36), leiomyosarcoma (n = 18), and sarcoma not otherwise classified (n = 12). Thirty-five patients underwent resection, 18 underwent resection plus radiofrequency ablation, and 13 underwent radiofrequency ablation only. With a median follow-up of 35.8 months, 44 patients (66.7%) had recurrence (intrahepatic only, n = 16; extrahepatic only, n = 11; both, n = 17). Treatment with radiofrequency ablation (either alone or combined with resection) (P = .002) and lack of adjuvant chemotherapy (P = .01) predicted shorter disease-free survival. The 1-, 3-, and 5-year overall survival rates were 91.2%, 65.4%, and 27.1%, respectively. Patients with gastrointestinal stromal tumor who were treated with adjuvant imatinib mesylate had the longest median survival (not reached) (P = .003).


CONCLUSIONS
Long-term survival can be achieved following surgical treatment of sarcoma liver metastasis, especially in patients with gastrointestinal stromal tumor. Patients with sarcoma liver metastasis should be evaluated by a multidisciplinary team, as recurrence is common and adjuvant therapy may prolong survival.
Pawlik
Timothy M
TM
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Vauthey
Jean-Nicolas
JN
Abdalla
Eddie K
EK
Pollock
Raphael E
RE
Ellis
Lee M
LM
Curley
Steven A
SA
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D004067:Digestive System Neoplasms / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012186:Retroperitoneal Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology
D000970:Antineoplastic Agents