Survival After Resection of Gastrointestinal Stromal Tumor and Sarcoma Liver Metastases in 146 Patients

Background: We investigated outcomes by primary tumor type in patients who underwent resection of liver metastases from gastrointestinal stromal tumors (GIST), leiomyosarcomas, and other sarcomas. Method: Our institutional liver database was used to identify patients who underwent resection from 1998 through 2013. Histopathological, clinical, and survival data were analyzed. Results: One hundred forty-six patients underwent resection of liver metastases from GIST (n = 49), leiomyosarcomas (n = 47), or other sarcomas (n = 50). The 5-year overall survival (OS) rates in patients with GIST, leiomyosarcomas, and other sarcomas were 55.3, 48.4, and 44.9 %, respectively, and the 10-year OS rates were 52.5, 9.2, and 23.0 %, respectively. The 5-year recurrence-free survival (RFS) rate was better for GIST (35.7 %; p = 0.003) than for leiomyosarcomas (3.4 %) and other sarcomas (21.4 %). Lung recurrence was more common for leiomyosarcomas (36 % of patients; p < 0.0001) than for other sarcomas (12 %) and GIST (2 %). For GIST, the findings support a benefit of imatinib regarding the 5-year RFS rate compared to resection alone (47.1 vs. 9.5 %; p = 0.013). For leiomyosarcoma, primary tumor location did not affect the 5-year RFS rate (intraabdominal 14.5 %; other location 0 %; p = 0.182). Conclusion: Liver metastases from GIST, leiomyosarcomas, and other sarcomas should be assessed separately as their survival and recurrence patterns are different. This is especially important for GIST, for which imatinib is now available.