Partial hepatectomy for liver metastases from nasopharyngeal carcinoma: a comparative study and review of the literature.
BACKGROUND
The management of liver metastases from nasopharyngeal carcinoma (NPC) has not been extensively investigated. This study aimed to compare the long-term outcome of patients with liver metastases from NPC who were treated by a partial hepatectomy or transcatheter hepatic artery chemoembolization (TACE).


METHODS
Between January 1993 and December 2010, 830 patients were diagnosed with liver metastases from NPC and exhibited a complete response to the primary cancer of the nasopharynx and regional lymph nodes. Fifteen patients with intrahepatic metastasis underwent R0 partial hepatectomy. As a parallel control group, another 15 patients with a resectable liver metastasis who underwent TACE were selected. Prior to the resection and TACE that were performed on patients in these two groups, radical radiotherapy with or without adjuvant chemotherapy was administered. Clinicopathological data and treatment outcomes were compared retrospectively.


RESULTS
No significant differences were observed between the two groups in terms of the clinicopathological features, which include gender ratio, liver function, accompanying cirrhosis, rate of infection with the hepatitis B virus, tumor size, tumor number, pathological type and preoperative comorbidities. The 1-, 3- and 5-year overall survival rates from the time of hepatectomy were 85.7%, 64.2% and 40.2%, respectively, with a median survival of 45.2 months, whereas the 1-, 3- and 5-year overall survival rates were 53.3%, 26.6% and 20.0% for patients in the control group (P = 0.039), respectively, with a median survival of 14.1 months. The actuarial median progression-free survival (PFS) of the patients in the resection group was 21.2 months, and the 1-, 3- and 5-year PFS rates were 70%, 53% and 18%, respectively. In the control group, the 1-, 3- and 5-year PFS rates were 27%, 7% and 0.0% (P = 0.007), respectively, with a median survival of 4.2 months. Thus far, 5 patients have survived for more than 5 years, and the longest survival time is 168.1 months.


CONCLUSIONS
For patients with limited liver metastases from NPC, hepatectomy provides a survival advantage over TACE. Due to the limited treatment options for patients with liver metastasis from NPC, hepatectomy should be recommended as an optimal treatment. Moreover, perioperative chemotherapy may be associated with an improved prognosis.
Jun
J
Huang
Qijiong
Q
Li
Yun
Y
Zheng
Jingxian
J
Shen
Binkui
B
Li
Ruhai
R
Zou
Jianping
J
Wang
Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Rd, E,, Guangzhou, Guangdong 510060, China. yuanyf@mail.sysu.edu.cn.
Yunfei
Y
Yuan
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D002277:Carcinoma; D016461:Chemoembolization, Therapeutic; D017024:Chemotherapy, Adjuvant; D018450:Disease Progression; D018572:Disease-Free Survival; D015251:Epirubicin / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery / Q000628:therapy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate
D015251:Epirubicin; D016685:Mitomycin; D004998:Ethiodized Oil; D016190:Carboplatin