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

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Journal of Gastrointestinal Surgery Aims and scope

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.

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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.

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Authors and Affiliations

  1. Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, Marchioninistr. 15, 81377, Munich, Germany

    Tobias S. Schiergens, Juliane Lüning, Bernhard W. Renz, Michael Thomas, Sebastian Pratschke, Hao Feng, Serene M. L. Lee, Markus Rentsch, Markus Guba, Jens Werner & Wolfgang E. Thasler

  2. Munich Cancer Registry (MCR) of the Munich Tumor Center (TZM), Institute for Medical Information Sciences, Biometry, and Epidemiology (IBE), University Hospital of Munich, Munich, Germany

    Jutta Engel

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  1. Tobias S. Schiergens
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Correspondence to Tobias S. Schiergens.

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

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The authors declare that they have no conflicts of interest.

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Schiergens, T.S., Lüning, J., Renz, B.W. et al. Liver Resection for Non-colorectal Non-neuroendocrine Metastases: Where Do We Stand Today Compared to Colorectal Cancer?. J Gastrointest Surg 20, 1163–1172 (2016). https://doi.org/10.1007/s11605-016-3115-1

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