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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 6/2016

01-06-2016 | Original Article

Liver Resection for Non-colorectal Non-neuroendocrine Metastases: Where Do We Stand Today Compared to Colorectal Cancer?

Authors: Tobias S. Schiergens, Juliane Lüning, Bernhard W. Renz, Michael Thomas, Sebastian Pratschke, Hao Feng, Serene M. L. Lee, Jutta Engel, Markus Rentsch, Markus Guba, Jens Werner, Wolfgang E. Thasler

Published in: Journal of Gastrointestinal Surgery | Issue 6/2016

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Abstract

The continuing controversy about surgery for non-colorectal non-neuroendocrine liver metastases (NCRNNE) necessitates identifying risk factors of worsened outcomes to improve patient selection and survival. Prospectively collected data of 167 patients undergoing hepatectomy for NCRNNE were analyzed, and a comparison to a matched population of colorectal liver metastases (CLM) was performed. Overall survival (OS) (35 vs. 54 months; P = 0.008) and recurrence-free survival (RFS) (15 vs. 29 months; P = 0.004) of NCRNNE patients were significantly shorter compared to those with CLM. The best survival was found in the genitourinary (GU; OS, 45 months; RFS, 21 months) NCRNNE subgroup, whereas survival for gastrointestinal (GI) metastases was low (OS, 8 months; RFS, 7 months). Patients with renal cell carcinoma (RCC) showed excellent outcomes when compared to CLM (OS, 50 vs. 51 months; P = 0.901). Extrahepatic disease (EHD) was identified as independent prognostic factor for reducing both RFS (P = 0.040) and OS (P = 0.046). The number of liver lesions (P = 0.024), residual tumor (P = 0.025), and major complications (P = 0.048) independently diminished OS. The degree of survival advantage by surgery is determined by the primary tumor site, EHD, the number of metastases, and residual tumor. Thus—even more than in CLM—these oncological selection criteria must prevail. GU metastases, especially RCC, represent a favorable subgroup.
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Metadata
Title
Liver Resection for Non-colorectal Non-neuroendocrine Metastases: Where Do We Stand Today Compared to Colorectal Cancer?
Authors
Tobias S. Schiergens
Juliane Lüning
Bernhard W. Renz
Michael Thomas
Sebastian Pratschke
Hao Feng
Serene M. L. Lee
Jutta Engel
Markus Rentsch
Markus Guba
Jens Werner
Wolfgang E. Thasler
Publication date
01-06-2016
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 6/2016
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-016-3115-1

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