Katrin Hoffmann1, Sümeyra Bulut2, Aysun Tekbas2, Ulf Hinz2, Markus W Büchler2, Peter Schemmer3. 1. Department of General, Visceral, and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany. katrin.hoffmann@med.uni-heidelberg.de. 2. Department of General, Visceral, and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany. 3. Department of General, Visceral, and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany. peter.schemmer@med.uni-heidelberg.de.
Abstract
BACKGROUND: Discussions about the benefit of liver resection (LRx) for non-colorectal, non-neuroendocrine metastases are controversial. This study aimed to analyze the outcome of LRx for these patients and validate a previously published prognostic risk model. METHODS: The study analyzed 150 patients who underwent LRx for non-colorectal non-neuroendocrine (NCNN) metastases. Patients' demographics, tumor characteristics, treatment options, and postoperative outcome were investigated. The Kaplan-Meier method and Cox regression models were used to assess survival and prognostic variables. RESULTS: After a median follow-up period of 61 months, 39 % of the patients were alive. The 30-day mortality rate was 0.7 %. The overall, disease-free, and intrahepatic recurrence-free survival rates were respectively 42, 29, and 51 % at 5 years and 28, 23, and 47 % at 10 years. The negative prognostic factors identified in the multivariate analysis were melanoma (p = 0.04), squamous tumors (p = 0.01), and a primary tumor liver metastasis, with an interval shorter than 2 years (p = 0.02), whereas the predictive prognostic factors identified were breast cancer (p = 0.04), stromal tumors (p = 0.03), and major LRx (p = 0.04). The prognostic risk score stratified patients into low risk (0-3 points: n = 50; 5-year overall survival [OS] 58 %), medium risk (4-6 points: n = 91; 5-year OS 35 %), and high risk (≥7 points: n = 9; 5-year OS, 33 %) groups (p = 0.01). CONCLUSION: Liver resection for patients with NCNN metastases is a safe treatment option. More than 25 % of patients can achieve a long-term survival of 10 years when the histology of the primary tumor and the surrogates for the individual biologic tumor behavior are taken into account. Exclusion of patients with NCNN liver metastases from surgical therapy is no longer justified.
BACKGROUND: Discussions about the benefit of liver resection (LRx) for non-colorectal, non-neuroendocrine metastases are controversial. This study aimed to analyze the outcome of LRx for these patients and validate a previously published prognostic risk model. METHODS: The study analyzed 150 patients who underwent LRx for non-colorectal non-neuroendocrine (NCNN) metastases. Patients' demographics, tumor characteristics, treatment options, and postoperative outcome were investigated. The Kaplan-Meier method and Cox regression models were used to assess survival and prognostic variables. RESULTS: After a median follow-up period of 61 months, 39 % of the patients were alive. The 30-day mortality rate was 0.7 %. The overall, disease-free, and intrahepatic recurrence-free survival rates were respectively 42, 29, and 51 % at 5 years and 28, 23, and 47 % at 10 years. The negative prognostic factors identified in the multivariate analysis were melanoma (p = 0.04), squamous tumors (p = 0.01), and a primary tumor liver metastasis, with an interval shorter than 2 years (p = 0.02), whereas the predictive prognostic factors identified were breast cancer (p = 0.04), stromal tumors (p = 0.03), and major LRx (p = 0.04). The prognostic risk score stratified patients into low risk (0-3 points: n = 50; 5-year overall survival [OS] 58 %), medium risk (4-6 points: n = 91; 5-year OS 35 %), and high risk (≥7 points: n = 9; 5-year OS, 33 %) groups (p = 0.01). CONCLUSION: Liver resection for patients with NCNN metastases is a safe treatment option. More than 25 % of patients can achieve a long-term survival of 10 years when the histology of the primary tumor and the surrogates for the individual biologic tumor behavior are taken into account. Exclusion of patients with NCNN liver metastases from surgical therapy is no longer justified.
Authors: Dayna P Y Sim; Brian K P Goh; Ser-Yee Lee; Chung-Yip Chan; Iain B H Tan; Peng-Chung Cheow; Premaraj Jeyaraj; Pierce K H Chow; London L P J Ooi; Alexander Y F Chung Journal: World J Surg Date: 2018-04 Impact factor: 3.352
Authors: Anastasia Murtha-Lemekhova; Juri Fuchs; Miriam Teroerde; Ute Chiriac; Rosa Klotz; Daniel Hornuss; Jan Larmann; Markus A Weigand; Katrin Hoffmann Journal: Antibiotics (Basel) Date: 2022-05-12
Authors: Ali Bohlok; Valerio Lucidi; Fikri Bouazza; Ali Daher; Desislava Germanova; Jean Luc Van Laethem; Alain Hendlisz; Vincent Donckier Journal: World J Surg Oncol Date: 2020-05-25 Impact factor: 2.754
Authors: Philipp Anton Holzner; Frank Makowiec; Andrea Klock; Torben Glatz; Stefan Fichtner-Feigl; Sven Arke Lang; Hannes Philipp Neeff Journal: BMC Surg Date: 2018-10-29 Impact factor: 2.102
Authors: Alexander Fischer; Juri Fuchs; Christos Stravodimos; Ulf Hinz; Adrian Billeter; Markus W Büchler; Arianeb Mehrabi; Katrin Hoffmann Journal: BMC Surg Date: 2020-11-30 Impact factor: 2.102