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

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

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.

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References

  1. Adam R, Chiche L, Aloia T, Elias D, Salmon R, Rivoire M, Jaeck D, Saric J, Le Treut YP, Belghiti J, Mantion G, Mentha G. Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model. Ann Surg 2006; 244(4):524–35.

    PubMed Central  PubMed  Google Scholar 

  2. Page AJ, Weiss MJ, Pawlik TM. Surgical management of noncolorectal cancer liver metastases. Cancer 2014; 120(20):3111–21.

    Article  PubMed  Google Scholar 

  3. Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg 1995; 19(1):59–71.

    Article  CAS  PubMed  Google Scholar 

  4. Sahai E. Illuminating the metastatic process. Nat Rev Cancer 2007; 7(10):737–49.

    Article  CAS  PubMed  Google Scholar 

  5. Katz SC, DeMatteo RP. Gastrointestinal stromal tumors and leiomyosarcomas. J Surg Oncol 2008; 97(4):350–9.

    Article  PubMed  Google Scholar 

  6. Pisters PW, Patel SR. Gastrointestinal stromal tumors: current management. J Surg Oncol 2010; 102(5):530–8.

    Article  PubMed  Google Scholar 

  7. Miettinen M, Kopczynski J, Makhlouf HR, Sarlomo-Rikala M, Gyorffy H, Burke A, Sobin LH, Lasota J. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the duodenum: a clinicopathologic, immunohistochemical, and molecular genetic study of 167 cases. Am J Surg Pathol 2003; 27(5):625–41.

    Article  PubMed  Google Scholar 

  8. Yamaguchi U, Hasegawa T, Masuda T, Sekine S, Kawai A, Chuman H, Shimoda T. Differential diagnosis of gastrointestinal stromal tumor and other spindle cell tumors in the gastrointestinal tract based on immunohistochemical analysis. Virchows Arch 2004; 445(2):142–50.

    Article  CAS  PubMed  Google Scholar 

  9. Sborov D, Chen JL. Targeted therapy in sarcomas other than GIST tumors. J Surg Oncol. 2014 Oct 20. doi:10.1002/jso.23802.

  10. Spira AI, Ettinger DS. The use of chemotherapy in soft-tissue sarcomas. Oncologist 2002; 7(4):348–59.

    Article  CAS  PubMed  Google Scholar 

  11. Lang H, Nussbaum KT, Kaudel P, Fruhauf N, Flemming P, Raab R. Hepatic metastases from leiomyosarcoma: a single-center experience with 34 liver resections during a 15-year period. Ann Surg 2000; 231(4):500–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Shima Y, Horimi T, Ishikawa T, Ichikawa J, Okabayashi T, Nishioka Y, Hamada M, Shibuya Y, Ishii T, Ito M. Aggressive surgery for liver metastases from gastrointestinal stromal tumors. J Hepatobiliary Pancreat Surg 2003; 10(1):77–80.

    PubMed  Google Scholar 

  13. Nunobe S, Sano T, Shimada K, Sakamoto Y, Kosuge T. Surgery including liver resection for metastatic gastrointestinal stromal tumors or gastrointestinal leiomyosarcomas. Jpn J Clin Oncol 2005; 35(6):338–41.

    Article  PubMed  Google Scholar 

  14. Rehders A, Peiper M, Stoecklein NH, Alexander A, Boelke E, Knoefel WT, Rogiers X. Hepatic metastasectomy for soft-tissue sarcomas: is it justified? World J Surg 2009; 33(1):111–7.

    Article  CAS  PubMed  Google Scholar 

  15. Sjolund K, Andersson A, Nilsson E, Nilsson O, Ahlman H, Nilsson B. Downsizing treatment with tyrosine kinase inhibitors in patients with advanced gastrointestinal stromal tumors improved resectability. World J Surg 2010; 34(9):2090–7.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Xia L, Zhang MM, Ji L, Li X, Wu XT. Resection combined with imatinib therapy for liver metastases of gastrointestinal stromal tumors. Surg Today 2010; 40(10):936–42.

    Article  CAS  PubMed  Google Scholar 

  17. Turley RS, Peng PD, Reddy SK, Barbas AS, Geller DA, Marsh JW, Tsung A, Pawlik TM, Clary BM. Hepatic resection for metastatic gastrointestinal stromal tumors in the tyrosine kinase inhibitor era. Cancer 2012; 118(14):3571–8.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Cananzi FC, Belgaumkar AP, Lorenzi B, Mudan S. Liver surgery in the multidisciplinary management of gastrointestinal stromal tumour. ANZ J Surg 2013; 84(12):937–42.

    Article  Google Scholar 

  19. DeMatteo RP, Shah A, Fong Y, Jarnagin WR, Blumgart LH, Brennan MF. Results of hepatic resection for sarcoma metastatic to liver. Ann Surg 2001; 234(4):540–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Pawlik TM, Vauthey JN, Abdalla EK, Pollock RE, Ellis LM, Curley SA. Results of a single-center experience with resection and ablation for sarcoma metastatic to the liver. Arch Surg 2006; 141(6):537–43.

  21. Aloia TA, Zorzi D, Abdalla EK, Vauthey JN. Two-surgeon technique for hepatic parenchymal transection of the noncirrhotic liver using saline-linked cautery and ultrasonic dissection. Ann Surg 2005; 242(2):172–7.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Joensuu H. Gastrointestinal stromal tumor (GIST). Ann Oncol 2006; 17 Suppl 10:x280–6.

    Article  PubMed  Google Scholar 

  23. Scaife CL, Hunt KK, Patel SR, Benjamin RS, Burgess MA, Chen LL, Trent J, Raymond AK, Cormier JN, Pisters PW, Pollock RE, Feig BW. Is there a role for surgery in patients with “unresectable” cKIT+ gastrointestinal stromal tumors treated with imatinib mesylate? Am J Surg 2003; 186(6):665–9.

    Article  PubMed  Google Scholar 

  24. Antonescu CR, Besmer P, Guo T, Arkun K, Hom G, Koryotowski B, Leversha MA, Jeffrey PD, Desantis D, Singer S, Brennan MF, Maki RG, DeMatteo RP. Acquired resistance to imatinib in gastrointestinal stromal tumor occurs through secondary gene mutation. Clin Cancer Res 2005; 11(11):4182–90.

    Article  CAS  PubMed  Google Scholar 

  25. Heinrich MC, Corless CL, Demetri GD, Blanke CD, von Mehren M, Joensuu H, McGreevey LS, Chen CJ, Van den Abbeele AD, Druker BJ, Kiese B, Eisenberg B, Roberts PJ, Singer S, Fletcher CD, Silberman S, Dimitrijevic S, Fletcher JA. Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol 2003; 21(23):4342–9.

    Article  CAS  PubMed  Google Scholar 

  26. Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 1999; 230(3):309–18.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The authors thank Stephanie Deming for editing the manuscript and Ruth J. Haynes for secretarial assistance in the preparation and submission of the manuscript.

This research was supported in part by the National Institutes of Health through MD Anderson’s Cancer Center Support Grant, CA016672. Dr. Brudvik is supported by the Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Norway, and was awarded the Unger-Vetlesen Medical Fund for 2014

Conflict of Interest

The authors report no conflicts of interest relevant to this article.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA

    Kristoffer W. Brudvik, Sameer H. Patel, Christina L. Roland, Claudius Conrad, Keila E. Torres, Kelly K. Hunt, Janice N. Cormier, Barry W. Feig, Thomas A. Aloia & Jean-Nicolas Vauthey

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  1. Kristoffer W. Brudvik
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  2. Sameer H. Patel
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  3. Christina L. Roland
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  4. Claudius Conrad
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  6. Kelly K. Hunt
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  7. Janice N. Cormier
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  8. Barry W. Feig
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  9. Thomas A. Aloia
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  10. Jean-Nicolas Vauthey
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Correspondence to Jean-Nicolas Vauthey.

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Brudvik, K.W., Patel, S.H., Roland, C.L. et al. Survival After Resection of Gastrointestinal Stromal Tumor and Sarcoma Liver Metastases in 146 Patients. J Gastrointest Surg 19, 1476–1483 (2015). https://doi.org/10.1007/s11605-015-2845-9

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