ASO Author Reflections: The Role of Primary Tumor Resection in Liver Metastasis

Abstract

Many patients have synchronous liver metastasis when diagnosed with primary cancer, the proportion varies from 0.3 to 35% according to the type of primary cancer. 1,2 A variety of malignant tumors, including primary tumors originating in the colorectum, gastrointestinal tract, pancreas, and breast, typically exhibit liver metastasis. The management of liver metastases patients is complex, and it is controversial whether to perform primary tumor resection (PTR). 3 PRESENT A total of 21,928 patients diagnosed with colorectal cancer liver metastases (CRLM), pancreatic cancer liver metastases (PLM), gastric cancer liver metastases (GLM), and breast cancer liver metastases (BLM) between 2004 and 2015 were retrospectively reviewed from the Surveillance, Epidemiology, and End Results (SEER) database to analyze the impact of PTR. We found that PTR was the benefit factor of survival of patients with CRLM, PLM, and BLM for both overall and cancer-specific survival. A nomogram was established on the basis of the factors of PTR benefit to identify the optimal candidates in CRLM for PTR. 4 FUTUREThis study analyzed four cancer types prone to liver metastases, hoping to obtain scientific results through a large administrative database to guide clinical treatment. 5 However, due to the inherent biases of the database, we could not simultaneously consider detailed information on treatment and complications, the number of liver metastases, and molecular profiling. Overall, future work should combine multiple platforms to gather more detailed variables and identify potential benefits for a broader population.