title: Liver Resection for Non-colorectal Non-neuroendocrine Metastases: Where Do We Stand Today Compared to Colorectal Cancer?
abstract: The continuing controversy about surgery for non-colorectal non-neuroendocrine liver metastases (NCRNNE) necessitates identifying risk factors of worsened outcomes to improve patient selection and survival. Prospectively collected data of 167 patients undergoing hepatectomy for NCRNNE were analyzed, and a comparison to a matched population of colorectal liver metastases (CLM) was performed. Overall survival (OS) (35 vs. 54 months; P = 0.008) and recurrence-free survival (RFS) (15 vs. 29 months; P = 0.004) of NCRNNE patients were significantly shorter compared to those with CLM. The best survival was found in the genitourinary (GU; OS, 45 months; RFS, 21 months) NCRNNE subgroup, whereas survival for gastrointestinal (GI) metastases was low (OS, 8 months; RFS, 7 months). Patients with renal cell carcinoma (RCC) showed excellent outcomes when compared to CLM (OS, 50 vs. 51 months; P = 0.901). Extrahepatic disease (EHD) was identified as independent prognostic factor for reducing both RFS (P = 0.040) and OS (P = 0.046). The number of liver lesions (P = 0.024), residual tumor (P = 0.025), and major complications (P = 0.048) independently diminished OS. The degree of survival advantage by surgery is determined by the primary tumor site, EHD, the number of metastases, and residual tumor. Thus-even more than in CLM-these oncological selection criteria must prevail. GU metastases, especially RCC, represent a favorable subgroup.
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany. Tobias.Schiergens@med.uni-muenchen.de.
authors.forename: Tobias S
authors.initials: TS
authors.lastname: Schiergens
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Juliane
authors.initials: J
authors.lastname: Lüning
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Bernhard W
authors.initials: BW
authors.lastname: Renz
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Pratschke
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Hao
authors.initials: H
authors.lastname: Feng
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Serene M L
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Munich Cancer Registry (MCR) of the Munich Tumor Center (TZM), Institute for Medical Information Sciences, Biometry, and Epidemiology (IBE), University Hospital of Munich, Munich, Germany.
authors.forename: Jutta
authors.initials: J
authors.lastname: Engel
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Rentsch
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Guba
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Werner
authors.affiliation: Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: Wolfgang E
authors.initials: WE
authors.lastname: Thasler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000556:secondary*; D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D018579:Patient Selection; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden; D055815:Young Adult
keywords: Liver resection; Metastasis; Non-colorectal; Non-neuroendocrine; Renal cell carcinoma