Long-term results of liver resection for non-colorectal, non-neuroendocrine metastases.
BACKGROUND
The safety and efficacy of liver resection for colorectal and neuroendocrine liver metastases is well established. However, there is lack of consensus regarding long-term effectiveness of hepatic resection for non-colorectal, non-neuroendocrine (NCNN) liver metastases.


METHODS
A review of prospectively collected data of patients undergoing hepatic resection for NCNN liver metastases at two tertiary referral centres in the UK and Australia was undertaken. Survival analysis was used to evaluate the clinical, demographic and operative factors associated with long-term survival.


RESULTS
A total of 114 hepatic resections in 102 patients were performed between 1986 and 2006. Postoperative mortality and morbidity was 0.8% and 21.1%, respectively. At 3 and 5 years overall survival was 56.1% and 38.5%, whereas disease-free survival was 37.2% and 26.5%, respectively. On multivariate analysis, factors associated with poor overall survival were diameter of liver metastasis [<5 cm versus >5 cm: hazard ratio (HR) = 2.83, p = 0.001] and the presence of extrahepatic nodal disease (HR = 3.58, p = 0.001). The type of tumor, the presence of distant extra-hepatic metastases, tumor-free interval, number and distribution of metastases did not effect long-term survival.


CONCLUSIONS
These results of the present study suggest that liver resection is an effective management option in selected patients with NCNN metastases confined to the liver.
O'Rourke
Thomas R
TR
Department of Hepatobiliary Surgery, Basingstoke and North Hampshire Foundation Trust, Basingstoke, United Kingdom. myrddinrees@btconnect.com
Tekkis
Paris
P
Yeung
Shinn
S
Fawcett
Jonathan
J
Lynch
Stephen
S
Strong
Russell
R
Wall
Daryl
D
John
Timothy G
TG
Welsh
Fenella
F
Rees
Myrddin
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D014565:Urogenital Neoplasms / Q000473:pathology / Q000601:surgery*