title: Surgery of liver metastasis in gynecological cancer - indication and results.
abstract: BACKGROUND
  Liver surgery for patients with liver metastases from gynecological malignancies, an indicator of advanced cancer disease, has remained unclear in the literature. We therefore analyzed the potential survival benefit of patients with surgically resectable compared to unresectable liver metastases.
  
  
  METHODS
  43 patients who underwent surgery for liver metastases from gynecological cancers were included in our retrospective observational analysis. Overall survival was estimated according to the Kaplan-Meier method and compared with the log-rank test.
  
  
  RESULTS
  Primary gynecological tumors were breast (n = 27), ovarian (n = 8), and uterine (n = 8) cancers. Solely exploratory laparotomy was performed in 13 patients who served as controls. Whereas the perioperative mortality was 0%, minor complications occurred in 18.7%. The overall survival of all patients undergoing liver resection was significantly higher (p < 0.05) than that of patients with unresectable metastases. Subgroup analyses showed that particularly patients with respectable liver metastases from breast cancer had a significantly higher (50%) 5-year survival compared to patients with only an exploratory laparotomy.
  
  
  CONCLUSIONS
  In selected patients, liver resection of metastases from gynecological cancers can achieve a survival benefit similar to that of patients with colorectal cancer metastases.
authors.affiliation: Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg/Saar, Germany.
authors.forename: Otto
authors.initials: O
authors.lastname: Kollmar
authors.forename: Mohammed R
authors.initials: MR
authors.lastname: Moussavian
authors.forename: Sven
authors.initials: S
authors.lastname: Richter
authors.forename: Martin
authors.initials: M
authors.lastname: Bolli
authors.forename: Martin K
authors.initials: MK
authors.lastname: Schilling
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality* / Q000601:surgery; D005858:Germany / Q000453:epidemiology; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008545:Melanoma / Q000097:blood / Q000401:mortality / Q000556:secondary; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012878:Skin Neoplasms / Q000097:blood* / Q000401:mortality*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome