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10.1245/s10434-007-9649-4
Annals of Surgical Oncology 15:207-218 (2008)
© 2008 Society of Surgical Oncology
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Original Article

Long-Term Results of Liver Resection for Noncolorectal, Nonneuroendocrine Metastases

Thomas R. O’Rourke, FRACS1,2, Paris Tekkis, MD, FRCS3, Shinn Yeung, FRACS2, Jonathan Fawcett, DPhil, FRCS, FRACS2, Stephen Lynch, FRACS2, Russell Strong, CMG, FRACS, FACS, FRCS2, Daryl Wall, FRACS2, Timothy G. John, MD, FRCS (Ed)1, Fenella Welsh, MD, FRCS1 and Myrddin Rees, MS, FRCS1

1 Department of Hepatobiliary Surgery, Basingstoke and North Hampshire Foundation Trust, Basingstoke, United Kingdom
2 Department of Hepatobiliary Surgery, Princess Alexandra Hospital, Brisbane, Australia
3 Department of Biosurgery and Surgical Technology, St Mary’s Hospital, Imperial College, London, United Kingdom

Correspondence: Address correspondence and reprint requests to: Myrddin Rees, MS, FRCS; E-mail: myrddinrees{at}btconnect.com

Introduction: The safety and efficacy of liver resection for colorectal and neuroendocrine liver metastases is well established. However, there is lack of consensus regarding long-term effectiveness of hepatic resection for noncolorectal, nonneuroendocrine (NCNN) liver metastases.

Methods: A review of prospectively collected data of patients undergoing hepatic resection for NCNN liver metastases at two tertiary referral centres in the UK and Australia was undertaken. Survival analysis was used to evaluate the clinical, demographic and operative factors associated with long-term survival.

Results: A total of 114 hepatic resections in 102 patients were performed between 1986 and 2006. Postoperative mortality and morbidity was 0.8% and 21.1%, respectively. At 3 and 5 years overall survival was 56.1% and 38.5%, whereas disease-free survival was 37.2% and 26.5%, respectively. On multivariate analysis, factors associated with poor overall survival were diameter of liver metastasis [<5 cm versus >5 cm: hazard ratio (HR) = 2.83, p = 0.001] and the presence of extrahepatic nodal disease (HR = 3.58, p = 0.001). The type of tumor, the presence of distant extrahepatic metastases, tumor-free interval, number and distribution of metastases did not effect long-term survival.

Conclusion: These results of the present study suggest that liver resection is an effective management option in selected patients with NCNN metastases confined to the liver.

Key Words: Hepatectomy • Non-colorectal • Non-neuroendocrine metastases






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