Top

Published in:

01-10-2011 | Original Article

Surgery for liver metastases originating from sarcoma—case series

Authors: Maximilian Zacherl, Gerwin A. Bernhardt, Johannes Zacherl, Gerald Gruber, Peter Kornprat, Heinz Bacher, Hans-Jörg Mischinger, Reinhard Windhager, Raimund Jakesz, Thomas Grünberger

Published in: Langenbeck's Archives of Surgery | Issue 7/2011

Abstract

Introduction

Liver metastases originating from various types of sarcoma are a rare reason for hepatic resection. So far, even multicentre studies do hardly provide statistically relevant sample sizes. Thus, review of available data can provide surgeons with useful information in similar cases. Therefore, this study can be regarded more as a contribution to this pool of data than as a stand-alone paper.

Patients and methods

The study includes 10 women and five men who underwent subtotal hepatic resection for solitary (n = 4) and multiple (n = 11) liver metastases originating from sarcoma. The median tumour diameter was 60 mm (range 20–200 mm).

Results

Morbidity was 33%. One patient died within 30 days after surgery. Resection was complete (R0) in 67%. Median overall survival was 33.6 months, 5-year survival 27%. The use of Pringle manoeuvre was significantly associated with poorer outcome (p = 0.014) and shorter period of recurrence-free survival (p = 0.012). Diameter of liver lesion over 50 mm showed significantly shorter recurrence-free survival (p = 0.042).

Conclusion

Hepatic resection may be beneficial in patients with isolated sarcoma metastasis in the liver.

Van Glabbeke M, van Oosterom AT, Oosterhuis JW et al (1999) Prognostic factors for the outcome of chemotherapy in advanced soft tissue sarcoma: an analysis of 2,185 patients treated with anthracycline-containing first-line regimens—a European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group Study. J Clin Oncol 17(1):150–157PubMed

Billingsley KG, Burt ME, Jara E et al (1999) Pulmonary metastases from soft tissue sarcoma: analysis of patterns of diseases and postmetastasis survival. Ann Surg 229(5):602–610, discussion 610–612PubMedCrossRef

Smith R, Pak Y, Kraybill W, Kane JM 3rd (2009) Factors associated with actual long-term survival following soft tissue sarcoma pulmonary metastasectomy. Eur J Surg Oncol 35(4):356–361PubMed

Jain A, Sajeevan KV, Babu KG, Lakshmaiah KC (2009) Chemotherapy in adult soft tissue sarcoma. Indian J Cancer 46(4):274–287PubMedCrossRef

Chen H, Pruitt A, Nicol TL et al (1998) Complete hepatic resection of metastases from leiomyosarcoma prolongs survival. J Gastrointest Surg 2(2):151–155PubMedCrossRef

Elias D, Cavalcantide de Albuquerque A, Eggenspieler P et al (1998) Resection of liver metastases from a noncolorectal primary: indications and results based on 147 monocentric patients. J Am Coll Surg 187(5):487–493PubMedCrossRef

Hemming AW, Sielaff TD, Gallinger S et al (2000) Hepatic resection of noncolorectal nonneuroendocrine metastases. Liver Transpl 6(1):97–101PubMed

Jaques DP, Coit DG, Casper ES, Brennan MF (1995) Hepatic metastases from soft-tissue sarcoma. Ann Surg 221(4):392–397PubMedCrossRef

Lang H, Nussbaum KT, Kaudel P et al (2000) Hepatic metastases from leiomyosarcoma: a single-center experience with 34 liver resections during a 15-year period. Ann Surg 231(4):500–505PubMedCrossRef

10.

Morrow CE, Grage TB, Sutherland DE, Najarian JS (1982) Hepatic resection for secondary neoplasms. Surgery 92(4):610–614PubMed

11.

O’Rourke TR, Tekkis P, Yeung S et al (2008) Long-term results of liver resection for non-colorectal, non-neuroendocrine metastases. Ann Surg Oncol 15(1):207–218PubMedCrossRef

12.

Zacherl M, Langle F, Steininger R et al (2001) Surgery for non-colorectal and non-neuroendocrine liver metastases. Wien Klin Wochenschr 113(17–18):681–687PubMed

13.

Zacherl J, Zacherl M, Scheuba C et al (2002) Analysis of hepatic resection of metastasis originating from gastric adenocarcinoma. J Gastrointest Surg 6(5):682–689PubMedCrossRef

14.

DeMatteo RP, Shah A, Fong Y et al (2001) Results of hepatic resection for sarcoma metastatic to liver. Ann Surg 234(4):540–547, discussion 547–548PubMedCrossRef

15.

Adam R, Chiche L, Aloia T et al (2006) Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model. Ann Surg 244(4):524–535PubMed

16.

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213PubMedCrossRef

17.

Pringle JHV (1908) Notes on the arrest of hepatic hemorrhage due to trauma. Ann Surg 48(4):541–549PubMedCrossRef

18.

Pawlik TM, Vauthey JN, Abdalla EK et al (2006) Results of a single-center experience with resection and ablation for sarcoma metastatic to the liver. Arch Surg 14(6):537–543, discussion 543–544

19.

Zalinski S, Palavecino M, Abdalla EK (2009) Hepatic resection for gastrointestinal stromal tumor liver metastases. Hematol Oncol Clin North Am 23(1):115–127, ixPubMedCrossRef

20.

Yap BS, Baker LH, Sinkovics JG et al (1980) Cyclophosphamide, vincristine, adriamycin, and DTIC (CYVADIC) combination chemotherapy for the treatment of advanced sarcomas. Cancer Treat Rep 64(1):93–98PubMed

21.

Ng EH, Pollock RE, Romsdahl MM (1992) Prognostic implications of patterns of failure for gastrointestinal leiomyosarcomas. Cancer 69(6):1334–1341PubMedCrossRef

22.

Verazin GT, Warneke JA, Driscoll DL et al (1992) Resection of lung metastases from soft-tissue sarcomas. A multivariate analysis. Arch Surg 127(12):1407–1411PubMed

23.

Ercolani G, Grazi GL, Ravaioli M et al (2005) The role of liver resections for noncolorectal, nonneuroendocrine metastases: experience with 142 observed cases. Ann Surg Oncol 12(6):459–466PubMedCrossRef

24.

Reddy SK, Barbas AS, Marroquin CE et al (2007) Resection of noncolorectal nonneuroendocrine liver metastases: a comparative analysis. J Am Coll Surg 204(3):372–382PubMedCrossRef

25.

Rehders A, Peiper M, Stoecklein NH et al (2009) Hepatic metastasectomy for soft-tissue sarcomas: is it justified? World J Surg 33(1):111–117PubMedCrossRef

26.

Mavligit GM, Zukwiski AA, Ellis LM et al (1995) Gastrointestinal leiomyosarcoma metastatic to the liver. Durable tumor regression by hepatic chemoembolization infusion with cisplatin and vinblastine. Cancer 75(8):2083–2088PubMedCrossRef

27.

Demetri GD, von Mehren M, Blanke CD et al (2002) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347(7):472–480PubMedCrossRef

28.

DeMatteo RP, Ballman KV, Antonescu CR et al (2009) Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial. Lancet 373(9669):1097–1104PubMedCrossRef

29.

DeMatteo RP, Maki RG, Singer S et al (2007) Results of tyrosine kinase inhibitor therapy followed by surgical resection for metastatic gastrointestinal stromal tumor. Ann Surg 245(3):347–352PubMedCrossRef

30.

Bernhard GA, Bacher H, Hagen D et al (2004) Heat shock protein 70: a new biomarker for ischemic–reperfusion injury due to Pringle maneuver. Eur Surg 36(5):305–310CrossRef

31.

El-Badry AM, Breitenstein S, Jochum W et al (2009) Assessment of hepatic steatosis by expert pathologists: the end of a gold standard. Ann Surg 250(5):691–697PubMedCrossRef

32.

Earle SA, Perez EA, Gutierrez JC et al (2006) Hepatectomy enables prolonged survival in select patients with isolated noncolorectal liver metastasis. J Am Coll Surg 203(4):436–446PubMedCrossRef

33.

Goering JD, Mahvi DM, Niederhuber JE et al (2002) Cryoablation and liver resection for noncolorectal liver metastases. Am J Surg 183(4):384–389PubMedCrossRef

34.

Harrison LE, Brennan MF, Newman E et al (1997) Hepatic resection for noncolorectal, nonneuroendocrine metastases: a fifteen-year experience with ninety-six patients. Surgery 121(6):625–632PubMedCrossRef

35.

Lendoire J, Moro M, Andriani O et al (2007) Liver resection for non-colorectal, non-neuroendocrine metastases: analysis of a multicenter study from Argentina. HPB (Oxford) 9(6):435–439

36.

van Ruth S, Mutsaerts E, Zoetmulder FA, van Coevorden F (2001) Metastasectomy for liver metastases of non-colorectal primaries. Eur J Surg Oncol 27(7):662–667PubMed

37.

Yedibela S, Gohl J, Graz V et al (2005) Changes in indication and results after resection of hepatic metastases from noncolorectal primary tumors: a single-institutional review. Ann Surg Oncol 12(10):778–785PubMedCrossRef

38.

Foster JH (1978) Survival after liver resection for secondary tumors. Am J Surg 135(3):389–394PubMedCrossRef

39.

Teo MC, Tan YM, Chung AY et al (2006) Metastectomy for non-colorectal, non-neuroendocrine liver secondaries. ANZ J Surg 76(7):575–578PubMedCrossRef

Title: Surgery for liver metastases originating from sarcoma—case series
Authors: Maximilian Zacherl
Gerwin A. Bernhardt
Johannes Zacherl
Gerald Gruber
Peter Kornprat
Heinz Bacher
Hans-Jörg Mischinger
Reinhard Windhager
Raimund Jakesz
Thomas Grünberger
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 7/2011
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-011-0821-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Surgery for liver metastases originating from sarcoma—case series

Abstract

Introduction

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2011

Ghost ileostomy after anterior resection for rectal cancer: a preliminary experience

Sonographic findings predictive of the need for surgical management in pediatric patients with small bowel intussusceptions

Gastric leakage after sleeve gastrectomy—clinical presentation and therapeutic options

Cytoreductive surgery and HIPEC in peritoneal recurrent ovarian cancer: experience and lessons learned

Repeat treatment for recurrent hepatocellular carcinoma: is it validated?

Plasma citrulline as marker of bowel adaptation in children with short bowel syndrome