TY - JOUR
T1 - Liver resection for liver metastases from nondigestive endocrine cancer
T2 - Extrahepatic disease burden defines outcome
AU - Andreou, Andreas
AU - Brouquet, Antoine
AU - Bharathy, Kishore G.S.
AU - Perrier, Nancy D.
AU - Abdalla, Eddie K.
AU - Curley, Steven A.
AU - Glanemann, Matthias
AU - Seehofer, Daniel
AU - Neuhaus, Peter
AU - Vauthey, Jean Nicolas
AU - Aloia, Thomas A.
N1 - Funding Information:
Supported in part by the National Institutes of Health through M D Anderson Cancer Center’s Support Grant CA016672 .
PY - 2012/6
Y1 - 2012/6
N2 - Background: For patients with hepatic nondigestive endocrine metastases (HNEM), the role of liver resection is not well-defined. Methods: We reviewed outcomes for patients who underwent liver resection for HNEM at 2 centers to identify predictors of survival. Results: From 1991 to 2010, 51 patients underwent liver resection for HNEM. Primary tumor types were adrenal gland (n = 26), thyroid (n = 11), testicular germ cell (n = 9), and ovarian granulosa cell (n = 5). 28 patients (55%) had synchronous or early (diagnosed within 12 months after primary tumor resection) liver metastases. At liver resection, 26 patients (51%) had extrahepatic metastases, and 7 (14%) had ≥2 sites of extrahepatic metastases. 32 patients (63%) had major liver resection and 19 (37%) had a simultaneous extrahepatic procedure. 90-day postoperative morbidity and mortality rates were 27% and 2%, respectively. After median follow-up of 20 months (range, 1-144), the 5-year overall and recurrence-free survival rates were 58% and 37%, respectively. Survival was not affected by primary tumor type. In multivariate analysis, ≥2 sites of extrahepatic metastases (hazard ratio [HR] = 4.80; 95% confidence interval [CI] = 1.18-19.50; P =.028) and interval of ≤12 months between primary tumor resection and diagnosis of liver metastases (HR = 5.33; 95% CI = 1.11-25.71; P =.037) were associated with worse overall survival after liver resection. Conclusion: For selected patients, liver resection for HNEM is associated with long-term survival. The number of extrahepatic sites of metastasis and the timing of appearance of liver metastases should be considered in patient selection.
AB - Background: For patients with hepatic nondigestive endocrine metastases (HNEM), the role of liver resection is not well-defined. Methods: We reviewed outcomes for patients who underwent liver resection for HNEM at 2 centers to identify predictors of survival. Results: From 1991 to 2010, 51 patients underwent liver resection for HNEM. Primary tumor types were adrenal gland (n = 26), thyroid (n = 11), testicular germ cell (n = 9), and ovarian granulosa cell (n = 5). 28 patients (55%) had synchronous or early (diagnosed within 12 months after primary tumor resection) liver metastases. At liver resection, 26 patients (51%) had extrahepatic metastases, and 7 (14%) had ≥2 sites of extrahepatic metastases. 32 patients (63%) had major liver resection and 19 (37%) had a simultaneous extrahepatic procedure. 90-day postoperative morbidity and mortality rates were 27% and 2%, respectively. After median follow-up of 20 months (range, 1-144), the 5-year overall and recurrence-free survival rates were 58% and 37%, respectively. Survival was not affected by primary tumor type. In multivariate analysis, ≥2 sites of extrahepatic metastases (hazard ratio [HR] = 4.80; 95% confidence interval [CI] = 1.18-19.50; P =.028) and interval of ≤12 months between primary tumor resection and diagnosis of liver metastases (HR = 5.33; 95% CI = 1.11-25.71; P =.037) were associated with worse overall survival after liver resection. Conclusion: For selected patients, liver resection for HNEM is associated with long-term survival. The number of extrahepatic sites of metastasis and the timing of appearance of liver metastases should be considered in patient selection.
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U2 - 10.1016/j.surg.2011.12.025
DO - 10.1016/j.surg.2011.12.025
M3 - Article
C2 - 22306838
AN - SCOPUS:84861606651
SN - 0039-6060
VL - 151
SP - 851
EP - 859
JO - Surgery (United States)
JF - Surgery (United States)
IS - 6
ER -