Abstract
The experience with hepatic resection for metastatic lesions, exclusive of colorectal and neuroendocrine tumors, is anecdotal. The reduction in operative mortality leads to a reconsideration of the subject. A review of the literature suggests a selective approach. These is little improvement to be anticipated for resection of metastases from tumors of the esophagus, stomach, small intestine, or pancreas. Resection of metastases from primary renal cell carcinoma, Wilms' tumor, and adrenocortical carcinoma is indicated. There is little to recommend resection of metastases from gynecologic or breast primary carcinomas. Resection as palliation is to be considered for all lesions, particularly bulky metastases from ocular melanomas.
Résumé
L'expérience acquise en matière de résection hépatique pour des lésions métastatiques en dehors des métastases d'origine colorectale ou endocrine, est tout à fait anecdotique. En raison de la réduction de la mortalité après chirurgie hépatique, cette situation mérite réflexion. Une revue de la littérature suggère une approche élective. On peut n'espérer que peu d'amélioration après la résection de métastases provenant des tumeurs de l'oesophage, de l'estomac, de l'intestin grêle, du pancréas, des cancers gynécologiques ou du sein. La résection de métastases provenant de cancers rénaux, des tumeurs de Wilms et des cancers de la corticosurrénale est, par contre, indiquée. La résection palliative est également à recommander surtout en cas de métastases volumineuses provenant des mélanomes oculaires.
Resumen
La experiencia con la resección hepática para lesiones metastásicas, excluyendo los tumores colo-rectales y neuroendorinos, es de tipo anecdótico. La reducción en la mortalidad operatoria lleva a la reconsideración del tema. Una revisión de la literatura pertinente sugiere un enfoque selectivo. Se puede anticipar que hay escaso progreso en lo referente a tumores del esófago, estómago, intestino delgado o páncreas. La resección de metástasis de carcinoma de células renales, tumor de Wilms y carcinoma adrenocortical está ìndicada. Hay poco que recomendar en cuanto a la resección de metástasis de carcinomas ginecológicos o mamarios. La resección como forma de paliación debe ser considerada en todo tipo de lesiones, particularmente metástasis voluminosas de melanomas oculares.
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Schwartz, S.I. Hepatic resection for noncolorectal nonneuroendocrine metastases. World J. Surg. 19, 72–75 (1995). https://doi.org/10.1007/BF00316982
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DOI: https://doi.org/10.1007/BF00316982