Liver resection for metastasis due to malignant mesenchymal tumours.

While liver resection for colorectal metastases has shown promising long-term survival, data for metastasectomy in sarcoma and leiomyosarcoma patients have not yielded the same optimism. Due to the rarity of the tumour entity it has always been difficult to provide significant data. Advances in tumour classification suggest that most of the metastases formerly classified to be of sarcomatoid and especially leiomyosarcomatoid origin are actually metastases of GISTs (gastro-intestinal stromal tumours). Neoadjuvant/adjuvant imatinib therapy might improve overall survival and enable surgeons to provide resections in previously unresectable patients. Only R0 resection has been proven to prolong survival so far, with a long disease-free interval as the only independent predictor of outcome.