Metastectomy for non-colorectal, non-neuroendocrine liver secondaries.
BACKGROUND
The role of metastectomy for colorectal and neuroendocrine liver secondaries is well established. Significant palliation and survival have been reported after aggressive surgical resection. However, the role of liver resection for secondaries from other primary tumours is less well defined. In this study, we aim to describe our experience, including indications and selection criteria, operative strategy and clinical outcome of liver resection, for non-colorectal, non-neuroendocrine liver metastases.


METHODS
A review of prospectively collected operative database was conducted and patients who underwent liver resection of secondaries from non-colorectal, non-neuroendocrine primary tumours were studied. Eighteen patients were included in the study. There were 4 men and 14 women with a median age of 48 years (range, 37-78 years).


RESULTS
Liver resection was carried out either for cure or for palliation of debilitating symptoms. Selection criteria included: (i) absence of extrahepatic disease and (ii) functional status of the liver and volume of remnant liver after hepatectomy. The median follow up was 24 months (range, 7-81 months) for 17 patients, excluding the one who defaulted after surgery. Cancer-specific survival and recurrence-free interval was calculated from the date of hepatectomy. Liver resection was considered curative in 13 patients. There was no 30-day mortality in this cohort of patients. The median recurrence-free survival time was 13 months (95% confidence interval (CI), 8-18 months). The median follow-up time for the 12 patients was 23.5 months (range, 7-35 months). Only five patients died due to cancer-specific causes and one died from acute myocardial infarction. The median cancer-specific survival time was 30 months (95% CI, 25-35 months). The 2-year survival rate was 77.1% (95% CI, 48.9-100%).


CONCLUSIONS
The results are encouraging and suggest that with appropriate selection criteria, there is a role for metastectomy of non-colorectal, non-neuroendocrine liver secondaries.
Teo
Melissa C
MC
Department of Surgical Oncology, National Cancer Centre of Singapore, Singapore. melteo1@gmail.com
Tan
Yu-Meng
YM
Chung
Alex Y
AY
Chow
Pierce K
PK
Cheow
Peng C
PC
Soo
Khee-Chee C
KC
Hee
Siew W
SW
Ooi
London L
LL
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome