Literature DB >> 21163386

Liver resection for metastatic soft tissue sarcoma: an analysis of prognostic factors.

R Marudanayagam1, B Sandhu, M T P R Perera, S R Bramhall, D Mayer, J A C Buckels, D F Mirza.   

Abstract

AIM: The aim of this retrospective study was to analyse the outcome following hepatic resection for metastatic STS and to identify factors predicting survival.
METHODS: All patients who underwent hepatic resection for metastatic STS between August 1997 and April 2009 were included. The data was obtained from a prospectively maintained database. Patients' demographics, clinico-pathological parameters, overall survival and the factors predicting survival were analysed.
RESULTS: Thirty-six patients underwent hepatic resection for metastasis, with a median age of 58 years. The predominant site of primary tumour was the gastro-intestinal tract (50%). Leiomyosarcoma was the most common histological type (54%). The median interval between the primary and metastatic resections was 17 months. Thirteen patients had synchronous tumours. 24 patients had major liver resections and 10 patients had bi-lobar disease. The median number of liver lesions resected was 1(1-6) and the median maximum diameter was 11 cm (1-26 cm). R0 resection was performed in 31 patients. The 1-, 3- and 5-year overall survival from the time of metastasectomy was 90.3%, 48.0% and 31.8% respectively, with a median survival of 24 months. Factors associated with poor survival on univariate analysis were the presence of high grade tumours (p = 0.04), primary leiomyosarcoma (p = 0.01) and positive resection margin of liver metastasis (p = 0.04), whilst multivariate analysis predicted primary leiomyosarcoma as a risk factor for poor survival (p = 0.01).
CONCLUSION: Hepatic resection for metastatic STS appears to be valuable in carefully selected patients with acceptable long-term survival. The aim of surgery must be an R0 resection to offer a chance of cure.
Copyright © 2010 Elsevier Ltd. All rights reserved.

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Year:  2011        PMID: 21163386     DOI: 10.1016/j.ejso.2010.11.006

Source DB:  PubMed          Journal:  Eur J Surg Oncol        ISSN: 0748-7983            Impact factor:   4.424


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