Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma

Jürgen Weitz, Leslie H. Blumgart, Yuman Fong, William R. Jarnagin, Michael D'Angelica, Lawrence E. Harrison, Ronald P. Dematteo

Research output: Contribution to journalArticle

152 Citations (Scopus)

Abstract

Objective: To define perioperative and long-term outcome and prognostic factors in patients undergoing hepatectomy for liver metastases arising from noncolorectal and nonneuroendocrine (NCNN) carcinoma. Summary Background Data: Hepatic resection is a well-established therapy for patients with liver metastases from colorectal or neuroendocrine carcinoma. However, for patients with liver metastases from other carcinomas, the value of resection is incompletely defined and still debated. Methods: Between April 1981 and April 2002, 141 patients underwent hepatic resection for liver metastases from NCNN carcinoma. Patient demographics, tumor characteristics, treatment, and postoperative outcome were analyzed. Results: Thirty-day postoperative mortality was 0% and 46 of 141 (33%) patients developed postoperative complications. The median follow up was 26 months (interquartile range [IQR]) 10-49 months); the median follow up for survivors was 35 months (IQR 11-68 months). There have been 24 actual 5-year survivors so far. The actuarial 3-year relapse-free survival rate was 30% (95% confidence interval [CI], 21-39%) with a median of 17 months. The actuarial 3-year cancer-specific survival rate was 57% (95% CI, 48-67%) with a median of 42 months. Primary tumor type and length of disease-free interval from the primary tumor were significant independent prognostic factors for relapse-free and cancer-specific survival. Margin status was significant for cancer-specific survival and showed a strong trend for relapse-free survival. Conclusions: Hepatic resection for metastases from NCNN carcinoma is safe and can offer long-term survival in selected patients. Hepatic resection should be considered if all gross disease can be removed, especially in patients with metastases from reproductive tract tumors or a disease-free interval greater than 2 years.

Original languageEnglish (US)
Pages (from-to)269-276
Number of pages8
JournalAnnals of Surgery
Volume241
Issue number2
DOIs
StatePublished - Feb 1 2005
Externally publishedYes

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Hepatectomy
Neoplasm Metastasis
Carcinoma
Liver
Neoplasms
Survival
Recurrence
Survivors
Survival Rate
Confidence Intervals
Neuroendocrine Carcinoma
Colorectal Neoplasms
Demography
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Weitz, J., Blumgart, L. H., Fong, Y., Jarnagin, W. R., D'Angelica, M., Harrison, L. E., & Dematteo, R. P. (2005). Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma. Annals of Surgery, 241(2), 269-276. https://doi.org/10.1097/01.sla.0000150244.72285.ad
Weitz, Jürgen ; Blumgart, Leslie H. ; Fong, Yuman ; Jarnagin, William R. ; D'Angelica, Michael ; Harrison, Lawrence E. ; Dematteo, Ronald P. / Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma. In: Annals of Surgery. 2005 ; Vol. 241, No. 2. pp. 269-276.
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Weitz, J, Blumgart, LH, Fong, Y, Jarnagin, WR, D'Angelica, M, Harrison, LE & Dematteo, RP 2005, 'Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma', Annals of Surgery, vol. 241, no. 2, pp. 269-276. https://doi.org/10.1097/01.sla.0000150244.72285.ad

Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma. / Weitz, Jürgen; Blumgart, Leslie H.; Fong, Yuman; Jarnagin, William R.; D'Angelica, Michael; Harrison, Lawrence E.; Dematteo, Ronald P.

In: Annals of Surgery, Vol. 241, No. 2, 01.02.2005, p. 269-276.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma

AU - Weitz, Jürgen

AU - Blumgart, Leslie H.

AU - Fong, Yuman

AU - Jarnagin, William R.

AU - D'Angelica, Michael

AU - Harrison, Lawrence E.

AU - Dematteo, Ronald P.

PY - 2005/2/1

Y1 - 2005/2/1

N2 - Objective: To define perioperative and long-term outcome and prognostic factors in patients undergoing hepatectomy for liver metastases arising from noncolorectal and nonneuroendocrine (NCNN) carcinoma. Summary Background Data: Hepatic resection is a well-established therapy for patients with liver metastases from colorectal or neuroendocrine carcinoma. However, for patients with liver metastases from other carcinomas, the value of resection is incompletely defined and still debated. Methods: Between April 1981 and April 2002, 141 patients underwent hepatic resection for liver metastases from NCNN carcinoma. Patient demographics, tumor characteristics, treatment, and postoperative outcome were analyzed. Results: Thirty-day postoperative mortality was 0% and 46 of 141 (33%) patients developed postoperative complications. The median follow up was 26 months (interquartile range [IQR]) 10-49 months); the median follow up for survivors was 35 months (IQR 11-68 months). There have been 24 actual 5-year survivors so far. The actuarial 3-year relapse-free survival rate was 30% (95% confidence interval [CI], 21-39%) with a median of 17 months. The actuarial 3-year cancer-specific survival rate was 57% (95% CI, 48-67%) with a median of 42 months. Primary tumor type and length of disease-free interval from the primary tumor were significant independent prognostic factors for relapse-free and cancer-specific survival. Margin status was significant for cancer-specific survival and showed a strong trend for relapse-free survival. Conclusions: Hepatic resection for metastases from NCNN carcinoma is safe and can offer long-term survival in selected patients. Hepatic resection should be considered if all gross disease can be removed, especially in patients with metastases from reproductive tract tumors or a disease-free interval greater than 2 years.

AB - Objective: To define perioperative and long-term outcome and prognostic factors in patients undergoing hepatectomy for liver metastases arising from noncolorectal and nonneuroendocrine (NCNN) carcinoma. Summary Background Data: Hepatic resection is a well-established therapy for patients with liver metastases from colorectal or neuroendocrine carcinoma. However, for patients with liver metastases from other carcinomas, the value of resection is incompletely defined and still debated. Methods: Between April 1981 and April 2002, 141 patients underwent hepatic resection for liver metastases from NCNN carcinoma. Patient demographics, tumor characteristics, treatment, and postoperative outcome were analyzed. Results: Thirty-day postoperative mortality was 0% and 46 of 141 (33%) patients developed postoperative complications. The median follow up was 26 months (interquartile range [IQR]) 10-49 months); the median follow up for survivors was 35 months (IQR 11-68 months). There have been 24 actual 5-year survivors so far. The actuarial 3-year relapse-free survival rate was 30% (95% confidence interval [CI], 21-39%) with a median of 17 months. The actuarial 3-year cancer-specific survival rate was 57% (95% CI, 48-67%) with a median of 42 months. Primary tumor type and length of disease-free interval from the primary tumor were significant independent prognostic factors for relapse-free and cancer-specific survival. Margin status was significant for cancer-specific survival and showed a strong trend for relapse-free survival. Conclusions: Hepatic resection for metastases from NCNN carcinoma is safe and can offer long-term survival in selected patients. Hepatic resection should be considered if all gross disease can be removed, especially in patients with metastases from reproductive tract tumors or a disease-free interval greater than 2 years.

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