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

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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.

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Authors and Affiliations

  1. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 20 College Road, Singapore, 169856, Singapore

    Dayna P. Y. Sim, Brian K. P. Goh, Ser-Yee Lee, Chung-Yip Chan, Peng-Chung Cheow, Premaraj Jeyaraj, Pierce K. H. Chow, London L. P. J. Ooi & Alexander Y. F. Chung

  2. University of Glasgow, Glasgow, Scotland, UK

    Dayna P. Y. Sim

  3. Duke NUS Medical School, Singapore, Singapore

    Brian K. P. Goh, Ser-Yee Lee, Iain B. H. Tan, Pierce K. H. Chow & London L. P. J. Ooi

  4. Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore

    Iain B. H. Tan

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  1. Dayna P. Y. Sim
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Correspondence to Brian K. P. Goh.

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Sim, D.P.Y., Goh, B.K.P., Lee, SY. et al. Preoperative Prognostic Factors After Liver Resection for Non-Colorectal, Non-Neuroendocrine Liver Metastases and Validation of the Adam Score in an Asian Population. World J Surg 42, 1073–1084 (2018). https://doi.org/10.1007/s00268-017-4208-z

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  • DOI: https://doi.org/10.1007/s00268-017-4208-z

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