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Journal of Gastrointestinal Surgery

, Volume 20, Issue 6, pp 1163–1172 | Cite as

Liver Resection for Non-colorectal Non-neuroendocrine Metastases: Where Do We Stand Today Compared to Colorectal Cancer?

  • Tobias S. SchiergensEmail author
  • Juliane Lüning
  • Bernhard W. Renz
  • Michael Thomas
  • Sebastian Pratschke
  • Hao Feng
  • Serene M. L. Lee
  • Jutta Engel
  • Markus Rentsch
  • Markus Guba
  • Jens Werner
  • Wolfgang E. Thasler
Original Article

Abstract

The continuing controversy about surgery for non-colorectal non-neuroendocrine liver metastases (NCRNNE) necessitates identifying risk factors of worsened outcomes to improve patient selection and survival. Prospectively collected data of 167 patients undergoing hepatectomy for NCRNNE were analyzed, and a comparison to a matched population of colorectal liver metastases (CLM) was performed. Overall survival (OS) (35 vs. 54 months; P = 0.008) and recurrence-free survival (RFS) (15 vs. 29 months; P = 0.004) of NCRNNE patients were significantly shorter compared to those with CLM. The best survival was found in the genitourinary (GU; OS, 45 months; RFS, 21 months) NCRNNE subgroup, whereas survival for gastrointestinal (GI) metastases was low (OS, 8 months; RFS, 7 months). Patients with renal cell carcinoma (RCC) showed excellent outcomes when compared to CLM (OS, 50 vs. 51 months; P = 0.901). Extrahepatic disease (EHD) was identified as independent prognostic factor for reducing both RFS (P = 0.040) and OS (P = 0.046). The number of liver lesions (P = 0.024), residual tumor (P = 0.025), and major complications (P = 0.048) independently diminished OS. The degree of survival advantage by surgery is determined by the primary tumor site, EHD, the number of metastases, and residual tumor. Thus—even more than in CLM—these oncological selection criteria must prevail. GU metastases, especially RCC, represent a favorable subgroup.

Keywords

Liver resection Metastasis Non-colorectal Non-neuroendocrine Renal cell carcinoma 

Notes

Acknowledgments

The authors thank Stephanie Schreiber, Dr. Carsta Stielow, and Dr. Hans-Martin Hornung for their dedicated work with the patients’ data collection and IT administration of the liver database.

Compliance with Ethical Standards

The study was approved by the ethics committee, Faculty of Medicine, Ludwig-Maximilians-University (LMU), Munich, Germany.

Conflict of Interest

The authors declare that they have no conflicts of interest.

Financial Support

No funding was received for the present study.

This article is not based on a previous communication to a society or meeting.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2016

Authors and Affiliations

  • Tobias S. Schiergens
    • 1
    Email author
  • Juliane Lüning
    • 1
  • Bernhard W. Renz
    • 1
  • Michael Thomas
    • 1
  • Sebastian Pratschke
    • 1
  • Hao Feng
    • 1
  • Serene M. L. Lee
    • 1
  • Jutta Engel
    • 2
  • Markus Rentsch
    • 1
  • Markus Guba
    • 1
  • Jens Werner
    • 1
  • Wolfgang E. Thasler
    • 1
  1. 1.Department of General, Visceral, Transplantation, Vascular and Thoracic SurgeryHospital of the University of MunichMunichGermany
  2. 2.Munich Cancer Registry (MCR) of the Munich Tumor Center (TZM), Institute for Medical Information Sciences, Biometry, and Epidemiology (IBE)University Hospital of MunichMunichGermany

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