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World Journal of Surgery

, Volume 42, Issue 4, pp 1073–1084 | Cite as

Preoperative Prognostic Factors After Liver Resection for Non-Colorectal, Non-Neuroendocrine Liver Metastases and Validation of the Adam Score in an Asian Population

  • Dayna P. Y. Sim
  • Brian K. P. GohEmail author
  • Ser-Yee Lee
  • Chung-Yip Chan
  • Iain B. H. Tan
  • Peng-Chung Cheow
  • Premaraj Jeyaraj
  • Pierce K. H. Chow
  • London L. P. J. Ooi
  • Alexander Y. F. Chung
Original Scientific Report

Abstract

Background

Historically, the benefit of liver resection for non-colorectal, non-neuroendocrine (NCNN) liver metastases has been controversial. This study aims to determine the preoperative prognostic factors of liver resection for NCNN liver metastases and validate the Adam score in an Asian population.

Methods

Consecutive patients who underwent liver resection for NCNN liver metastases were identified retrospectively from a prospective liver resection database of the single institution between 2001 and 2014. Univariate Cox regression models were used to identify associations with outcome variables. Recurrence-free interval and overall survival were determined using the Kaplan–Meier method and compared using log-rank test.

Results

Seventy-eight consecutive patients were identified, which met the study criteria. Univariate analysis demonstrated that adenocarcinoma histology of primary cancer, disease-free interval and number of nodules were significant predictors of survival. Four of the six components of Adam score were significant predictors of survival. These were the presence of extrahepatic metastases, R2 resection, disease-free interval and type of a primary tumour. The total Adam score was also a significant predictor of survival.

Conclusion

Liver resection for NCNN liver metastases is a safe and viable treatment option in carefully selected patients. Significant preoperative prognostic factors include adenocarcinoma primary tumours, disease-free interval and number of nodules. The total Adam score was a good predictor of overall survival and can be used to risk stratify patients undergoing hepatic resection for NCNN liver metastases.

References

  1. 1.
    Hallet J, Sa Cunha A, Adam R, Goere D, Bachellier P, Azoulay D et al (2016) Factors influencing recurrence following initial hepatectomy for colorectal liver metastases. Br J Surg 103:1366–1376CrossRefPubMedGoogle Scholar
  2. 2.
    Sarmiento JM, Heywood G, Rubin J, Ilstrup DM, Nagorney DM, Que FG (2003) Surgical treatment of neuroendocrine metastases to the liver. J Am Coll Surg 197(1):29–37CrossRefPubMedGoogle Scholar
  3. 3.
    Rossi RE, Massironi S, Spampatti MP, Conte D, Ciafardini C, Cavalcoli F et al (2012) Treatment of liver metastases in patients with digestive neuroendocrine tumors. J Gastrointest Surg 16(10):1981–1992CrossRefPubMedGoogle Scholar
  4. 4.
    Slotta JE, Schuld J, Distler S, Richter S, Schilling MK, Kollmar O (2014) Hepatic resection of non-colorectal and non-neuroendocrine liver metastases—survival benefit for patients with non-gastrointestinal primary cancers—a case-controlled study. Int J Surg 12(2):163–168CrossRefPubMedGoogle Scholar
  5. 5.
    Schmelzle M, Eisenberger CF, am Esch JS II, Matthaei H, Krausch M, Knoefel WT (2010) Non-colorectal, non-neuroendocrine, and non-sarcoma metastases of the liver: resection as a promising tool in the palliative management. Langenbecks Arch Surg 395(3):227–234CrossRefPubMedGoogle Scholar
  6. 6.
    Uggeri F, Ronchi PA, Goffredo P, Garancini M, Degrate L, Nespoli L et al (2015) Metastatic liver disease from non-colorectal, non-neuroendocrine, non-sarcoma cancers: a systematic review. World J Surg Oncol 13:191CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Yamada H, Katoh H, Kondo S, Okushiba S, Morikawa T (2001) Hepatectomy for metastases from non-colorectal and non-neuroendocrine tumor. Anticancer Res 21(6A):4159–4162PubMedGoogle Scholar
  8. 8.
    Schiergens TS, Luning J, Renz BW, Thomas M, Pratschke S, Feng H et al (2016) Liver resection for non-colorectal non-neuroendocrine metastases: Where do we stand today compared to colorectal cancer? J Gastrointest Surg 20(6):1163–1172CrossRefPubMedGoogle Scholar
  9. 9.
    Hoffmann K, Bulut S, Tekbas A, Hinz U, Buchler MW, Schemmer P (2015) Is hepatic resection for non-colorectal, non-neuroendocrine liver metastases justified? Ann Surg Oncol 22(Suppl 3):S1083–S1092CrossRefPubMedGoogle Scholar
  10. 10.
    Fitzgerald TL, Brinkley J, Banks S, Vohra N, Englert ZP, Zervos EE (2014) The benefits of liver resection for non-colorectal, non-neuroendocrine liver metastases: a systematic review. Langenbecks Arch Surg 399(8):989–1000CrossRefPubMedGoogle Scholar
  11. 11.
    Clarke NA, Kanhere HA, Trochsler MI, Maddern GJ. Liver resection for non-colorectal non-neuroendocrine metastases. ANZ J Surg. doi: 10.1111/ans.13700
  12. 12.
    O’Rourke TR, Tekkis P, Yeung S, Fawcett J, Lynch S, Strong R et al (2008) Long-term results of liver resection for non-colorectal, non-neuroendocrine metastases. Ann Surg Oncol 15(1):207–218CrossRefPubMedGoogle Scholar
  13. 13.
    Adam R, Chiche L, Aloia T, Elias D, Salmon R, Rivoire M et al (2006) Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1452 patients and development of a prognostic model. Ann Surg 244(4):524–535PubMedPubMedCentralGoogle Scholar
  14. 14.
    Lendoire J, Moro M, Andriani O, Grondona J, Gil O, Raffin G et al (2007) Liver resection for non-colorectal, non-neuroendocrine metastases: analysis of a multicenter study from Argentina. HPB (Oxford) 9(6):435–439CrossRefGoogle Scholar
  15. 15.
    Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196CrossRefPubMedGoogle Scholar
  16. 16.
    Groeschl RT, Nachmany I, Steel JL, Reddy SK, Glazer ES, de Jong MC et al (2012) Hepatectomy for noncolorectal non-neuroendocrine metastatic cancer: a multi-institutional analysis. J Am Coll Surg 214(5):769–777CrossRefPubMedGoogle Scholar
  17. 17.
    Maeda Y, Shinohara T, Katayama T, Futakawa N, Hamada T (2015) Hepatectomy for liver metastases in non-colorectal, non-neuroendocrine cancer patients. The survival benefit in primary unresectable cases. Int J Surg 22:136–142CrossRefPubMedGoogle Scholar
  18. 18.
    Adam R, Delvart V, Gr Pascal, Valeanu A, Castaing D, Azoulay D et al (2004) Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy. Trans Meet Am Surg Assoc CXXII:242–256Google Scholar
  19. 19.
    Simmonds PC, Primrose JN, Colquitt JL, Garden OJ, Poston GJ, Rees M (2006) Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies. Br J Cancer 94(7):982–999CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Gandy RC, Bergamin PA, Haghighi KS (2016) Hepatic resection of non-colorectal non-endocrine liver metastases. ANZ J Surg. doi: 10.1111/ans.13470
  21. 21.
    Yedibela S, Gohl J, Graz V, Pfaffenberger MK, Merkel S, Hohenberger W et al (2005) Changes in indication and results after resection of hepatic metastases from noncolorectal primary tumors: a single-institutional review. Ann Surg Oncol 12(10):778–785CrossRefPubMedGoogle Scholar
  22. 22.
    Martel G, Hawel J, Rekman J, Croome KP, Bertens K, Balaa FK et al (2015) Liver resection for non-colorectal, non-carcinoid, non-sarcoma metastases: a multicenter study. PLoS ONE 10(3):e0120569CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Jr Weitz, Blumgart LH, Fong Y, Jarnagin WR, D’Angelica M, LE Harrison et al (2005) Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma. Ann Surg 241(2):269–276CrossRefGoogle Scholar
  24. 24.
    Sadot E, Lee SY, Sofocleous CT, Solomon SB, Gonen M, Peter Kingham T et al (2016) Hepatic resection or ablation for isolated breast cancer liver metastasis: a case–control study with comparison to medically treated patients. Ann Surg 264(1):147–154CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Reddy SK, Barbas AS, Marroquin CE, Morse MA, Kuo PC, Clary BM (2007) Resection of noncolorectal nonneuroendocrine liver metastases: a comparative analysis. J Am Coll Surg 204(3):372–382CrossRefPubMedGoogle Scholar
  26. 26.
    Abbott DE, Brouquet A, Mittendorf EA, Andreou A, Meric-Bernstam F, Valero V et al (2012) Resection of liver metastases from breast cancer: estrogen receptor status and response to chemotherapy before metastasectomy define outcome. Surgery 151(5):710–716CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Dayna P. Y. Sim
    • 1
    • 2
  • Brian K. P. Goh
    • 1
    • 3
    Email author
  • Ser-Yee Lee
    • 1
    • 3
  • Chung-Yip Chan
    • 1
  • Iain B. H. Tan
    • 3
    • 4
  • Peng-Chung Cheow
    • 1
  • Premaraj Jeyaraj
    • 1
  • Pierce K. H. Chow
    • 1
    • 3
  • London L. P. J. Ooi
    • 1
    • 3
  • Alexander Y. F. Chung
    • 1
  1. 1.Department of Hepatopancreatobiliary and Transplant SurgerySingapore General HospitalSingaporeSingapore
  2. 2.University of GlasgowGlasgowScotland, UK
  3. 3.Duke NUS Medical SchoolSingaporeSingapore
  4. 4.Division of Medical OncologyNational Cancer Centre SingaporeSingaporeSingapore

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