title: Hepatic Resection is Safe for Metachronous Hepatic Metastases from Ovarian Cancer.
abstract: OBJECTIVE
  To explore the efficacy of hepatic resection (HR) in a relatively unselected group of patients with ovarian cancer liver metastases (OCLM).
  
  
  METHODS
  A study was conducted between September 2000 and September 2011 on 60 ovarian cancer patients with hepatic metastases (24 solitary and 36 multiple), 40 of whom had extrahepatic metastases. HR was done in all patients provided that curative hepatic resection was feasible, and extrahepatic disease was controlled with medical and/or surgical therapy.
  
  
  RESULTS
  Most patients (n=54; 90.0%) had a negative hepatic margin (R0), whereas 6 patients (10.0%) had microscopic disease at the margin (R1). The prognostic value of each study variable was assessed using log rank tests for univariate analysis and Cox proportional hazard models for multivariate analysis. The result was a median survival of 39 months and 5-year overall survival rate of 30%. Univariate analysis showed that surgery result (P=0.001), disease free interval (P=0.018) and the number of hepatic lesions (P=0.018) were significantly related to survival. Furthermore, the surgery result (P=0.004) remained significant for prognosis in multivariate analysis.
  
  
  CONCLUSIONS
  For patients with OCLM, HR is safe and may provide a signiﬁcant survival beneﬁt compared with medical therapy alone. A long interval time, the number of hepatic lesions, and surgery results are key prognostic factors. Favorable outcomes can be achieved even in patients with medically controlled or surgically resectable extrahepatic disease, indicating that surgery should be considered more frequently in the multidisciplinary care of patients with OCLM.
authors.affiliation: Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.
authors.forename: Guang-Cai
authors.initials: GC
authors.lastname: Niu
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Shen
authors.forename: Wei
authors.initials: W
authors.lastname: Cui
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
keywords: hepatectomy; liver metastasis; ovarian cancer