Noncolorectal, Nonneuroendocrine Liver Metastasis

2019 ◽  
Author(s):  
Lindsay A. Bliss ◽  
Thomas Clark Gamblin

Noncolorectal, nonneuroendocrine metastases represent a heterogeneous group with variable tumor biology. Successes in the use of hepatectomy for colorectal liver metastases has increased interest in resection of noncolorectal, nonneuroendocrine metastases. Cure rates equivalent to those of colorectal liver metastases have not been achieved, but resection of noncolorectal, nonneuroendocrine metastases can often provide improved overall survival compared with systemic therapy alone or exclusively palliative care. Overall survival outcomes can be achieved with acceptable perioperative morbidity and mortality relative to rates for hepatectomies in general. Prospective data regarding the utilization of resection for noncolorectal, nonneuroendocrine metastases are lacking, but retrospective data are encouraging. In appropriately selected patients with favorable tumor biology and excellent performance status, resection of noncolorectal, nonneuroendocrine may offer a survival benefit. This review contains 1 figure, 2 tables, and 31 references. Key Words: breast cancer, cytoreduction, gastric cancer, GIST, hepatectomy, melanoma, metastasis, ovarian cancer, pancreatic cancer, renal cell carcinoma

2019 ◽  
Author(s):  
Lindsay A. Bliss ◽  
Thomas Clark Gamblin

Noncolorectal, nonneuroendocrine metastases represent a heterogeneous group with variable tumor biology. Successes in the use of hepatectomy for colorectal liver metastases has increased interest in resection of noncolorectal, nonneuroendocrine metastases. Cure rates equivalent to those of colorectal liver metastases have not been achieved, but resection of noncolorectal, nonneuroendocrine metastases can often provide improved overall survival compared with systemic therapy alone or exclusively palliative care. Overall survival outcomes can be achieved with acceptable perioperative morbidity and mortality relative to rates for hepatectomies in general. Prospective data regarding the utilization of resection for noncolorectal, nonneuroendocrine metastases are lacking, but retrospective data are encouraging. In appropriately selected patients with favorable tumor biology and excellent performance status, resection of noncolorectal, nonneuroendocrine may offer a survival benefit. This review contains 1 figure, 2 tables, and 31 references. Key Words: breast cancer, cytoreduction, gastric cancer, GIST, hepatectomy, melanoma, metastasis, ovarian cancer, pancreatic cancer, renal cell carcinoma


2015 ◽  
Vol 100 (9-10) ◽  
pp. 1276-1280
Author(s):  
Osama Damrah ◽  
Panagis M. Lykoudis ◽  
Rafael Orti-Rodriguez ◽  
Theodora Pissanou ◽  
Dinesh Sharma ◽  
...  

The purpose of this retrospective study was to investigate whether patients over 70 years old are at significantly higher risk for worse outcomes following major liver resection. Hepatic resection is the only treatment offering long-term survival for patients with colorectal liver metastases. As the population considered for metastasectomy is aging, there are still controversial published results regarding the safety of major hepatectomy in elderly patients. Between December 2002 and April 2010, 327 patients underwent major liver resection for colorectal liver metastasis. Patients were stratified into 2 groups: group A, <70 years old; and group B, ≥70 years old. Recorded, analyzed, and compared data across groups included the following: (1) patient characteristics including age, sex, American Society of Anesthesiologists performance status, primary tumor site and stage, adjuvant chemotherapy, number and size of metastatic lesions; (2) perioperative data including extent of resection, in-hospital mortality, postoperative morbidity, length of hospital stay, length of intensive treatment unit stay and blood loss; and (3) overall survival. The patients' characteristics were similar as were the characteristics of their tumors. There was no difference in overall morbidity (25% versus 22%) or postoperative mortality (2.6% versus 2.9%) (P = 0.44 and 0.57, respectively). The overall survival was 67% versus 62% in group A and B, respectively (P = 0.09). Elderly patients can safely undergo major liver resection for colorectal liver metastases with short- and long-term outcomes comparable with younger patients.


2015 ◽  
Vol 87 (2) ◽  
Author(s):  
Wacław Hołówko ◽  
Michał Grąt ◽  
Karolina Maria Wronka ◽  
Jan Stypułkowski ◽  
Rafał Roszkowski ◽  
...  

AbstractLiver is the most common location of the colorectal cancer metastases occurrence. Liver resection is the only curative method of treatment. Unfortunately it is feasible only in 25% of patients with colorectal liver metastases, often because of the extensiveness of the disease.The aim of the study was to evaluate the predictive value of total tumor volume, size and number of colorectal liver metastases in patients treated with right hemihepatectomy.Material and methods. A retrospective analysis was performed in a group of 135 patients with colorectal liver metastases, who were treated with right hemihepatectomy. Total tumor volume was estimated based on the formula (4/3)πr3. Moreover, the study included an analysis of data on the number and size of tumors, radicality of the resection, time between primary tumor resection and liver resection, pre-operative blood serum concentration of carcinoembryonal antigen (CEA) and carcinoma antigen Ca19-9. The predictive value of the factors was evaluated by applying a Cox proportional hazards model and the area under the ROC curve.Results. The univariate analysis has shown the predictive value of size of the largest tumor (p=0.033; HR=1.065 per each cm) on the overall survival, however no predictive value of number of tumors (p=0.997; HR=1.000) and total tumor volume (p=0.212; HR=1.002) was observed. The multivariate analysis did not confirm the predictive value of the size of the largest tumor (p=0.141; HR=1.056). In the analysis of ROC curves, AUROC for the total tumor volume, the size of the largest tumor and the number of tumors were 0.629, 0.608, 0.520, respectively.Conclusions. Total tumor volume, size and number of liver metastases are not independent risk factors for the worse overall survival of patients with colorectal liver metastases treated with liver resection, therefore increased values of these factors should not be a contraindication for surgical treatment


2019 ◽  
Vol 269 (1) ◽  
pp. e3-e4 ◽  
Author(s):  
Gu-Wei Ji ◽  
Ke Wang ◽  
Yong-Xiang Xia ◽  
Xiang-Cheng Li ◽  
Xue-Hao Wang

2018 ◽  
Vol 55 (3) ◽  
pp. 258-263 ◽  
Author(s):  
Claudemiro QUIREZE JUNIOR ◽  
Andressa Machado Santana BRASIL ◽  
Lúcio Kenny MORAIS ◽  
Edmond Raymond Le CAMPION ◽  
Eliseu José Fleury TAVEIRA ◽  
...  

ABSTRACT BACKGROUND: Liver metastases from colorectal cancer are an important public health problem due to the increasing incidence of colorectal cancer worldwide. Synchronous colorectal liver metastasis has been associated with worse survival, but this prognosis is controversial. OBJECTIVE: The objective of this study was to evaluate the recurrence-free survival and overall survival between groups of patients with metachronous and synchronous colorectal hepatic metastasis. METHODS: This was a retrospective analysis of medical records of patients with colorectal liver metastases seen from 2013 to 2016, divided into a metachronous and a synchronous group. The Cox regression model and the Kaplan-Meier method with log-rank test were used to compare survival between groups. RESULTS: The mean recurrence-free survival was 9.75 months and 50% at 1 year in the metachronous group and 19.73 months and 63.3% at 1 year in the synchronous group. The mean overall survival was 20.00 months and 6.2% at 3 years in the metachronous group and 30.39 months and 31.6% at 3 years in the synchronous group. Patients with metachronous hepatic metastasis presented worse overall survival in multivariate analysis. The use of biological drugs combined with chemotherapy was related to the best overall survival prognosis. CONCLUSION: Metachronous colorectal hepatic metastasis was associated with a worse prognosis for overall survival. There was no difference in recurrence-free survival between metachronous and synchronous metastases.


Sign in / Sign up

Export Citation Format

Share Document