Keiji Sano1, Masakazu Yamamoto2, Tetsushige Mimura3, Itaru Endo4, Shoji Nakamori5, Masaru Konishi6, Masaru Miyazaki7, Toshifumi Wakai8, Masato Nagino9, Keiichi Kubota10, Michiaki Unno11, Naohiro Sata12, Junji Yamamoto13, Hiroki Yamaue14, Tadahiro Takada1. 1. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan. 2. Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University Hospital, Tokyo, Japan. 3. Department of Surgery, Okayama Saiseikai General Hospital, Okayama, Japan. 4. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 5. Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan. 6. Department of Hepatobiliary-Pancreatic Surgery, National Cancer Center Hospital East, Tokyo, Japan. 7. Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. 8. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 9. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. 10. Second Department of Surgery, Dokkyo Medical University, Mibu, Japan. 11. Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. 12. Department of Surgery, Jichi Medical University, Shimotsuke, Japan. 13. Department of Surgery, National Defense Medical College, Tokorozawa, Japan. 14. Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.
Abstract
BACKGROUND: Whether non-colorectal non-neuroendocrine liver metastasis (NCNNLM) should be treated surgically remains unclear. METHODS: Data regarding 1,639 hepatectomies performed between 2001 and 2010 for 1,539 patients with NCNNLM were collected from 124 institutions. Patient characteristics, types of primary tumor, characteristics of liver metastases, and post-hepatectomy outcomes were analyzed. RESULTS: The five most frequent primary tumors were gastric carcinoma (540 patients [35%]), gastrointestinal stromal tumor (204 patients [13%]), biliary carcinoma (150 patients [10%]), ovarian cancer (107 patients [7%]), and pancreatic carcinoma (77 patients [5%]). R0/1 hepatectomy was achieved in 90% of patients, with 1.5% in-hospital mortality rate. Overall and disease-free survival rates of 1,465 patients included in survival analysis were 41% and 21%, respectively, at 5 years, and 28% and 15%, respectively, at 10 years. Five-year survival associated with the five frequent primary tumors were 32%, 72%, 17%, 52%, and 31%, respectively, and factors predictive of a poor outcome differed by the primary tumor type. CONCLUSIONS: Our data indicated that hepatectomy is safe for NCNNLM and that patient prognoses vary depending on the type of primary tumors. Indications for hepatectomy should be determined with reference to survival rates and risk factors specific to each of the various types of primary tumor.
BACKGROUND: Whether non-colorectal non-neuroendocrine liver metastasis (NCNNLM) should be treated surgically remains unclear. METHODS: Data regarding 1,639 hepatectomies performed between 2001 and 2010 for 1,539 patients with NCNNLM were collected from 124 institutions. Patient characteristics, types of primary tumor, characteristics of liver metastases, and post-hepatectomy outcomes were analyzed. RESULTS: The five most frequent primary tumors were gastric carcinoma (540 patients [35%]), gastrointestinal stromal tumor (204 patients [13%]), biliary carcinoma (150 patients [10%]), ovarian cancer (107 patients [7%]), and pancreatic carcinoma (77 patients [5%]). R0/1 hepatectomy was achieved in 90% of patients, with 1.5% in-hospital mortality rate. Overall and disease-free survival rates of 1,465 patients included in survival analysis were 41% and 21%, respectively, at 5 years, and 28% and 15%, respectively, at 10 years. Five-year survival associated with the five frequent primary tumors were 32%, 72%, 17%, 52%, and 31%, respectively, and factors predictive of a poor outcome differed by the primary tumor type. CONCLUSIONS: Our data indicated that hepatectomy is safe for NCNNLM and that patient prognoses vary depending on the type of primary tumors. Indications for hepatectomy should be determined with reference to survival rates and risk factors specific to each of the various types of primary tumor.
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