Prognostic Factors Affecting Long-Term Survival after Resection for Noncolorectal, Nonneuroendocrine, and Nonsarcoma Liver Metastases

Abstract

Aim To evaluate feasibility and long-term outcome after hepatic resection for noncolorectal, nonneuroendocrine, and nonsarcoma (NCNNNS) liver metastases in a single center. Methods We retrospectively reviewed our experience on patients who underwent surgery for NCNNNS liver metastases from 1995 to 2015. Patient baseline characteristics, tumor features, treatment options, and postoperative outcome were retrieved. Results We included 47 patients. The overall 5-year survival (OS) rate after hepatectomy was 27.6%, with a median survival of 21 months. Overall survival was significantly longer for patients operated for nongastrointestinal liver metastases when compared with gastrointestinal (41 versus 10 months; p = 0.027). OS was significantly worse in patients with synchronous metastases than in those with metachronous disease (10 versus 22 months; p = 0.021). The occurrence of major postoperative complication negatively affected long-term prognosis (OS 23.5 versus 9.0 months; p = 0.028). Preoperative tumor characteristics (number and size of the lesions), intraoperative features (extension of resection, need for transfusions, and Pringle's maneuver), and R0 at pathology were not associated with differences in overall survival. Conclusion Liver resection represents a possible curative option for patients with NCNNNS metastases. The origin of the primary tumor and the timing of metastases presentation may help clinicians to better select which patients could take advantages from surgical intervention.

Surgical treatment of liver metastases from kidney cancer: a systematic review

“…Figure depicts the flow diagram of article selection, according to the PRISMA statement. Thirteen articles were finally included, with a total of 378 patients. None of the retrieved studies were randomized and all of them were retrospective observational cohort reports.…”

Laparoscopic liver resection for non-colorectal non-neuroendocrine metastases: perioperative and oncologic outcomes

“…However, since the introduction of the model, there has been more focus on patient selection which resulted in further variability of populations between studies. Some authors excluded metastases of sarcomatous origin intentionally, considering them as a well-defined indication for liver resection with good outcomes [21, 39, 40]. However, different subtypes of sarcomas should be assessed separately as their behavior is different [41].…”

“…In our series, we found 16 patients (31%) with stable or resectable extrahepatic disease (EHD). These patients are frequently not considered for surgery [39]. In Adam’s study, EHD was not a contraindication for surgery but patients with extrahepatic metastases had worse survival compared to patients with metastatic disease limited to the liver.…”