Hepatectomy for Noncolorectal Non-Neuroendocrine Metastatic Cancer: A Multi-Institutional Analysis

Groeschl, Ryan T.; Nachmany, Ido; Steel, Jennifer L.; Reddy, Srinevas K.; Glazer, Evan S.; Jong, Mechteld C. de; Pawlik, Timothy M.; Geller, David A.; Tsung, Allan; Marsh, J. Wallis; Clary, Bryan M.; Curley, Steven A.; Gamblin, T. Clark

doi:10.1016/j.jamcollsurg.2011.12.048

Cited by 127 publications

(138 citation statements)

References 45 publications

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“…Surgery remains the gold standard curative option with 5-year survival rates around 70% for patients with small HCC and early stage cirrhosis, and with 1 and 5-year survival for selected isolated hepatic metastases (colorectal and non-colorectal primaries) of about 95% and 40%, respectively. 1,2,6 Unfortunately, greater than 80% of patients with hepatic metastases are not candidates for hepatectomy at the time of initial presentation. 1,5 Likewise most hepatomas are not resectable due to size, location or liver function impairment.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,6 Unfortunately, greater than 80% of patients with hepatic metastases are not candidates for hepatectomy at the time of initial presentation. 1,5 Likewise most hepatomas are not resectable due to size, location or liver function impairment. Radiofrequency ablation (RFA) can be an alternative to surgery however, analysis of a prospective database at a tertiary care center demonstrates that RFA for solitary colorectal cancer metastasis not amendable for safe resection is associated with a higher local recurrence rates and shorter recurrence-free and overall survival compared with hepatic resections even when small lesions ( 3 cm) are considered.…”

Section: Discussionmentioning

confidence: 99%

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Stereotactic body radiotherapy (SBRT) with or without surgery for primary and metastatic liver tumors.

Kirichenko¹,

Parda²,

Sanguino³

et al. 2016

JCO

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Objectives: We report single center experience on the outcome and toxicity of SBRT alone or in combination with surgery for inoperable primary and metastatic liver tumors between 2007 and 2014.Patients and methods: Patients with 1-4 hepatic lesions and tumor diameter 9 cm received SBRT at 46.8Gy ± 3.7 in 4-6 fractions. The primary end point was local control with at least 6 months of radiographic followup, and secondary end points were toxicity and survival.Results: Eighty-seven assessable patients (114 lesions) completed liver SBRT for hepatoma (39) or isolated metastases (48) with a median followup of 20.3 months (range 1.9-64.1). Fourteen patients underwent liver transplant with SBRT as a bridging treatment or for tumor downsizing. Eight patients completed hepatic resections in combination with planned SBRT for unresectable tumors. Two-year local control was 96% for hepatoma and 93.8% for metastases; it was 100% for lesions 4 cm. Two-year overall survival was 82.3% (hepatoma) and 64.3% (metastases). No incidence of grade >2 treatment toxicity was observed. Conclusion:In this retrospective analysis we demonstrate that liver SBRT alone or in combination with surgery is safe and effective for the treatment of isolated inoperable hepatic malignancies and provides excellent local control rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stereotactic body radiotherapy (SBRT) with or without surgery for primary and metastatic liver tumors.

Kirichenko¹,

Parda²,

Sanguino³

et al. 2016

JCO

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“…Surgical resection of colorectal liver metastases is an established form of treatment (4,5). Current literature also supports the hepatic metastasectomies for the primary tumors other than colorectal and neuroendocrine origin like gynecological tumors (5).…”

Section: Dıscussıonmentioning

confidence: 99%

“…The resection of metachronous, liver and lung metastases prolongs survival despite the aggressive nature of these tumors (4). Although hepatic metastasectomy is well established for colorectal and neuroendocrine tumors, the treatment of hepatic metastases from other primary sites is not well defined (5 (5). There is also some data to suggest a longer survival after lung metastasectomy for gynecologic malignancies (6).…”

Section: Introductıonmentioning

confidence: 99%

Transthoracic Transdiaphragmatic Resection for Liver Metastasis of Ovarian Carcinosarcoma with Invasion of Right Hemidiaphragm and Lung.

Çakmak¹,

Karaman²,

Çetin³

et al. 2015

Acta Oncol Tur.

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ÖZETKolorektal ve nöroendokrin tümörlerde hepatik metastazektominin klinik faydası çok iyi tanımlanmış olmasına karşın, diğer tümörlerinde bu uygulamanın yeri çok net değildir. Bu yazıda over karsinosarkomuna bağlı sağ hemidiafragma ve sağ akciğer alt lobunu invaze etmiş karaciğer metastazlı bir olgu sunmaktayız. Bu olguya abdominal girişim uygulanmadan transtorasik olarak yaklaşılmış ve sağ hemidiafragma, akciğer ve karaciğer rezeksiyonu uygulanmıştır. Hasta bu cerrahi girişim sonrası ortalama 2,5 yıl (27 ay) yaşamıştır. Primer jinekolojik malignitelere bağlı uzak organ metastazlarında da, düşük morbidite ve mortalite oranları ve sağ kalımı uzaması nedeniyle senkron hepatik ve pulmoner metastazektomi uygulanabilir. Bu alanda kısıtlı tecrübeler olmasına rağmen özellikle subdiafragmatik karaciğer ile sağ akciğere olan metastazlarda, transtorasik senkron pulmoner ve hepatik metastazektomi akılda tutulmalıdır. Anahtar Kelimeler: Over karsinosarkomu, senkron, karaciğer, akciğer, metastazektomi ABSTRACT Although hepatic metastasectomy is well established for colorectal and neuroendocrine tumors, the treatment of hepatic metastases from other sites is not well defined. We present a case of ovarian carcinosarcoma with liver metastasis that invaded the right hemidiaphragm and lower lobe of right lung. En bloc transthoracic lung, right hemidiaphragm and liver resection was performed without using an abdominal incision. The patient survived nearly 2.5 years (27 months) after this surgery. Synchronous hepatic and pulmonary metastasectomies can be recommended for the metastatic tumors from the primary gynecologic malignancies. This procedure can be done with low morbidity, mortality rates and prolonges survival. Inspite of the limited experience, the choice of transthoracic synchronous pulmonary and hepatic metastasectomy should be remembered for the patients with subdiapragmatic liver and right sided lung metastasis.

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“…En estos casos, la resección hepática de las metástasis se basa en que la mayor parte de la carga tumoral en el paciente está limitada al abdomen, por lo que un tratamiento adecuado del tumor primario, en combinación con la resección de las MH, puede plantearse con posibilidades de curación. Por otro lado, un elevado número de MH proceden de tumores originados fuera de la cavidad abdominal que, por lo general, utilizan la circulación sistémica para alcanzar el hígado, pudiéndose afectar otras localizaciones extrahepáticas con igual probabilidad [1][2][3] . Los primeros trabajos sobre MH no colorrectales tratados mediante resección hepática incluyeron tumores neuroendocrinos y no neuroendocrinos, mostrando mejor pronóstico el grupo de MH de origen neuroendocrino [3][4][5][6][7][8] .…”

Section: Metástasis Hepáticas De Origen No Colorrectal Ni Neuroendocrunclassified

Metástasis Hepáticas De Origen No Colorrectal Ni Neuroendocrino: Tratamiento en Un Hospital De Segundo Nivel

et al. 2015

Rev Chil Cir

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liver metastases from non-colorectal non-neuroendocrine tumors. treatment in a hospital of second level introduction: Surgical treatment of liver metastases is broadly accepted for colorectal and neuroendocrine tumors. However, the approach to liver metastases of other origins is not well established. The objective is the evaluation of factors that might be associated with better or worse perioperative outcomes (morbidity and mortality) and survival of patients with non-colorectal, non-neuroendocrine liver metastases (nCnnLM) treated surgically in a second level hospital. material and methods: A prospective study of patients with nCnnLM treated surgically or with radiofrequency was completed in San Cecilio University Hospital of Granada, between March 2003 and June 2013. The statistical analysis was made with IBM-SPSS version 21. Statistical significance was set at p ≤ 0.05. Survival data were analyzed by Kaplan-Meier´s method. results: Twenty-two patients with 26 surgeries were analyzed, 19 liver resections, 6 radiofrequency treatments and 1 combined case with surgery and radiofrequency. Operatory mortality was 0% and overage mortality was 23.1%. Univariate analysis only showed statistical significance in two of the factors, presence of positive lymphatic nodes during the surgery of the primary tumor and presence of extra-hepatic disease. Accumulated survival was 81%, 66% and 52% at 1, 2 and 3 years respectively. conclusions: Despite the fact of treating together in the same group several different tumors, the surgical treatment of nCnnLM (with or without radiofrequency) has an acceptable survival rate. Thus, they can be treated with safety when we use a multidisciplinary approach to these patients.

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Hepatectomy for Noncolorectal Non-Neuroendocrine Metastatic Cancer: A Multi-Institutional Analysis

Cited by 127 publications

References 45 publications

Stereotactic body radiotherapy (SBRT) with or without surgery for primary and metastatic liver tumors.

Stereotactic body radiotherapy (SBRT) with or without surgery for primary and metastatic liver tumors.

Transthoracic Transdiaphragmatic Resection for Liver Metastasis of Ovarian Carcinosarcoma with Invasion of Right Hemidiaphragm and Lung.

Metástasis Hepáticas De Origen No Colorrectal Ni Neuroendocrino: Tratamiento en Un Hospital De Segundo Nivel

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