Partial hepatectomy for liver metastases from nasopharyngeal carcinoma: a comparative study and review of the literature

Abstract

BackgroundThe 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).MethodsBetween 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.ResultsNo 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.ConclusionsFor 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.

Minimally invasive treatment of oligometastasis in the liver in recurrent nasopharyngeal carcinoma

“…All of them demonstrated initial complete response, but were found to have either oligometastasis (n = 2) or sync-oligometastasis (n = 2) after a mean of 21.3 months from previous radiotherapy. All of them had a solitary metastatic lesion in the liver, and the mean size of the intrahepatic lesion was much smaller compared to that of the previous report treated by partial hepatectomy [10] . In our highly selected group of patients with small and solitary liver metastasis from NPC, RFA appears to be an effective local treatment with minimal morbidities and short hospital stay.…”

“…In a subsequent study, 15 patients with liver metastasis from NPC were treated by partial hepatectomy, and the Published: 2016-02-15 ★ DOI:10.15383/jnpc.30 e-ISSN 2312-0398 Table 2. Clinical data and outcome of percutaneous radiofrequency frequency ablation of liver metastasis after radiotherapy for NPC outcomes were compared with another cohort of patients treated by transcatheter hepatic artery chemoembolization (TACE) [10] . The polymetastatic cancers in which local therapy could achieve long-term survival or cure, with no restrictions on primary lesions [17,18] .…”

“…In a recent study of 15 patients with TACE performed for liver metastasis from NPC [10] , the 1-, 3-and 5-year progression free survival rates were 27%, 7% and 0%, respectively, and the median survival was 4.2 months. Hepatectomy results in a significantly better survival rates and median survival.…”

Use of the liver maximum function capacity test (LiMAx) for the management of liver resection in cirrhosis – A case of hypopharyngeal cancer liver metastasis

“…If liver metastasis represents the only systemic tumor spread, surgery is a feasible therapeutic option in these patients [3] . An improved survival for patients with nasopharyngeal carcinoma who received partial hepatectomy over patients treated interventionally was already shown [4] .…”

OVOL2 in metastasis prevention in NPC

“…The main treatment for primary NPC patients is radiotherapy with or without chemotherapy, with locally advanced disease associated with a 50-70% five-year survival rate. Moreover, 10% of cases present with distant metastasis into other organs, such as bones, lungs, liver, and distant lymph nodes 1 and are associated with very poor outcomes 2 , 3 . In metastatic disease, chemotherapy remains the mainstay of care, though resistance inevitably develops 3 .…”