BACKGROUND: For patients with hepatic nondigestive endocrine metastases (HNEM), the role of liver resection is not well-defined. METHODS: We reviewed outcomes for patients who underwent liver resection for HNEM at 2 centers to identify predictors of survival. RESULTS: From 1991 to 2010, 51 patients underwent liver resection for HNEM. Primary tumor types were adrenal gland (n = 26), thyroid (n = 11), testicular germ cell (n = 9), and ovarian granulosa cell (n = 5). 28 patients (55%) had synchronous or early (diagnosed within 12 months after primary tumor resection) liver metastases. At liver resection, 26 patients (51%) had extrahepatic metastases, and 7 (14%) had ≥2 sites of extrahepatic metastases. 32 patients (63%) had major liver resection and 19 (37%) had a simultaneous extrahepatic procedure. 90-day postoperative morbidity and mortality rates were 27% and 2%, respectively. After median follow-up of 20 months (range, 1-144), the 5-year overall and recurrence-free survival rates were 58% and 37%, respectively. Survival was not affected by primary tumor type. In multivariate analysis, ≥2 sites of extrahepatic metastases (hazard ratio [HR] = 4.80; 95% confidence interval [CI] = 1.18-19.50; P = .028) and interval of ≤12 months between primary tumor resection and diagnosis of liver metastases (HR = 5.33; 95% CI = 1.11-25.71; P = .037) were associated with worse overall survival after liver resection. CONCLUSION: For selected patients, liver resection for HNEM is associated with long-term survival. The number of extrahepatic sites of metastasis and the timing of appearance of liver metastases should be considered in patient selection.
BACKGROUND: For patients with hepatic nondigestive endocrine metastases (HNEM), the role of liver resection is not well-defined. METHODS: We reviewed outcomes for patients who underwent liver resection for HNEM at 2 centers to identify predictors of survival. RESULTS: From 1991 to 2010, 51 patients underwent liver resection for HNEM. Primary tumor types were adrenal gland (n = 26), thyroid (n = 11), testicular germ cell (n = 9), and ovarian granulosa cell (n = 5). 28 patients (55%) had synchronous or early (diagnosed within 12 months after primary tumor resection) liver metastases. At liver resection, 26 patients (51%) had extrahepatic metastases, and 7 (14%) had ≥2 sites of extrahepatic metastases. 32 patients (63%) had major liver resection and 19 (37%) had a simultaneous extrahepatic procedure. 90-day postoperative morbidity and mortality rates were 27% and 2%, respectively. After median follow-up of 20 months (range, 1-144), the 5-year overall and recurrence-free survival rates were 58% and 37%, respectively. Survival was not affected by primary tumor type. In multivariate analysis, ≥2 sites of extrahepatic metastases (hazard ratio [HR] = 4.80; 95% confidence interval [CI] = 1.18-19.50; P = .028) and interval of ≤12 months between primary tumor resection and diagnosis of liver metastases (HR = 5.33; 95% CI = 1.11-25.71; P = .037) were associated with worse overall survival after liver resection. CONCLUSION: For selected patients, liver resection for HNEM is associated with long-term survival. The number of extrahepatic sites of metastasis and the timing of appearance of liver metastases should be considered in patient selection.
Authors: Jean-Nicolas Vauthey; Timothy M Pawlik; Eddie K Abdalla; James F Arens; Rabih A Nemr; Steven H Wei; Debra L Kennamer; Lee M Ellis; Steven A Curley Journal: Ann Surg Date: 2004-05 Impact factor: 12.969
Authors: Felix G Fernandez; Jeffrey A Drebin; David C Linehan; Farrokh Dehdashti; Barry A Siegel; Steven M Strasberg Journal: Ann Surg Date: 2004-09 Impact factor: 12.969
Authors: Eddie K Abdalla; Jean-Nicolas Vauthey; Lee M Ellis; Vickie Ellis; Raphael Pollock; Kristine R Broglio; Kenneth Hess; Steven A Curley Journal: Ann Surg Date: 2004-06 Impact factor: 12.969
Authors: Daniel Puhr-Westerheide; Clemens C Cyran; Josef Sargsyan-Bergmann; Andrei Todica; Franz-Josef Gildehaus; Wolfgang G Kunz; Robert Stahl; Christine Spitzweg; Jens Ricke; Philipp M Kazmierczak Journal: Cancer Imaging Date: 2019-11-14 Impact factor: 3.909