Resection of Noncolorectal and Nonneuroendocrine Liver
Metastases: Late Metastases Are the Only Chance of Cure |
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Authors: | Christophe Laurent MD Eric Rullier MD Anne Feyler MD Bernard Masson MD Jean Saric MD |
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Institution: | (1) Department of Surgery, Saint-André Hospital, 1 Rue Jean Burguet, 33075 Bordeaux, France, FRANCE;(2) Department of Statistics, Pellegrin Hospital, 12 Place Amélie Raba-Léon, 33076 Bordeaux, France, FRANCE;(3) Department of Surgery, Haut Lévèque Hospital, 6 Avenue Magellan, 33604 Pessac, France, FRANCE |
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Abstract: | Resection of liver colorectal metastases
allows a 5-year survival in 25% to 35% of patients. The outcome of
patients with noncolorectal metastases is unknown because of the
heterogeneity of this group. The aim of this retrospective study was to
evaluate predictive factors of survival in patients who underwent
resection of noncolorectal and nonneuroendocrine (NCRNE) liver
metastases. From 1980 to 1997, 284 patients underwent hepatectomy for
liver metastases of whom 39 (25 men and 14 women, mean age 55 years)
had curative resection for NCRNE liver metastases. No patients had
extrahepatic disease. The primary tumors were gastrointestinal (n
= 15), genitourinary (n = 12) and miscellaneous (n = 12). The
mean number of metastases was 1.8, and the mean size of the lesions was
51 mm. The median disease-free interval was 27 months. Twenty patients
had a major hepatectomy and 19 a minor resection, with
simultaneous resection of the primary in 6 cases. Overall survival was
evaluated using the Kaplan-Meier method. There was no operative
mortality, and 8% morbidity. The survival at 1, 3, and 5 years was 81,
40, and 35%, respectively. Patients with a disease-free interval
higher than 24 months had a greater survival rate than those with a
disease-free interval of less than 24 months (100% vs. 10%;
p = 0.0004). Survival was not significantly influenced
by age, sex, type of primary tumor, number, size and localization of
metastases, type of hepatectomy, or blood transfusion. Resection of
NCRNE liver metastases should be justified for patients without
extrahepatic disease and resectable metastases, especially for those
who have a disease-free interval of more than 24 months. |
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Keywords: | |
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