Complete hepatic resection of metastases from leiohyosarcoma prolongs survival |
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Authors: | Chen Herbert Pruitt Anita Nicol Theresa L Gorgulu Semih Cboti Michael A |
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Institution: | (1) Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, Md.;(2) Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Md.;(3) Department of Surgery, Halsted 614, 600 N. Wolfe St., 21287 Baltimore, MD |
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Abstract: | Although liver resection has been shown to prolong survival in selected patients with metastases from colorectal cancer, the
benefit for other metastatic tumors is unproved. To determine whether hepatic resection has a role in the management of metastatic
leiomyosarcoma, medical records from 11 consecutive patients who underwent resection of isolated metastases from leiomyosarcoma
between 1984 and 1995 were reviewed. All liver resections were for leiomyosarcomas originating in the viscera (n = 6) or retroperitoneum
(n = 5). The average disease-free interval was 16 months. Five of 11 primary tumors were classified as low grade, whereas
six were high grade. Hepatic resections included lobectomy or extended lobectomy (n = 4), segmentectomy and/or wedge resection
(n = 5), and complex resection (n = 2). There were no operative deaths. Median survival of all patients after liver resection
was 39 months. Patients who underwent complete resection of hepatic metastases (n = 6) had a significantly longer survival
than those who had incomplete resections (n = 5) (P = 0.03, log-rank test). Furthermore, five of six patients who underwent complete resection are alive after hepatectomy with
a median follow-up of 53 months. Therefore, in selected patients with isolated liver metastases from visceral and retroperitoneal
leiomyosarcomas, complete resection of hepatic metastases results in prolonged survival.
Presented in part at the Fiftieth Annual Cancer Symposium of the Society of Surgical Oncology, Chicago, Ill., March 20–23,
1997. |
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