A very interesting study regarding the value of liver resection for NCNELM. Many different studies have regarded this procedure as controversial due to the heterogeneity of the tumor localization and tumor type.
To do this 41 centers from Europe and USA gathered and reviewed their information from 1983 to 2004, and came up with 1452 patients. The results of their study showed that hepatic metastases were solitary in 56% and unilateral in 71% (mean diameter, 50.5 mm). Extrahepatic metastases were present in 22%. The most common primary sites were breast (32%), gastrointestinal (16%), and urologic (14%). The most common histologies were adenocarcinoma (60%), GIST/sarcoma (13.5%), and melanoma (13%). R0 resection was achieved in 83% of patients with a 60-day mortality rate of 2.3% and a major complication rate
of 21.5%. Tumor recurred in 67% of patients (liver, 24%; extrahepatic, 18%; both, 25%). Overall and disease-free survivals at 5 years were 36% and 21% and at 10 years were 23% and 15%, respectively.
What they conclude is that patient selection is very important, and outcomes depend on tumor site and histology. They showed that patients with certain prognostic factors could be managed by surgical resection with long term survivals.
Annals of Surgery Vol 244(4), October 2006.
To do this 41 centers from Europe and USA gathered and reviewed their information from 1983 to 2004, and came up with 1452 patients. The results of their study showed that hepatic metastases were solitary in 56% and unilateral in 71% (mean diameter, 50.5 mm). Extrahepatic metastases were present in 22%. The most common primary sites were breast (32%), gastrointestinal (16%), and urologic (14%). The most common histologies were adenocarcinoma (60%), GIST/sarcoma (13.5%), and melanoma (13%). R0 resection was achieved in 83% of patients with a 60-day mortality rate of 2.3% and a major complication rate
of 21.5%. Tumor recurred in 67% of patients (liver, 24%; extrahepatic, 18%; both, 25%). Overall and disease-free survivals at 5 years were 36% and 21% and at 10 years were 23% and 15%, respectively.
What they conclude is that patient selection is very important, and outcomes depend on tumor site and histology. They showed that patients with certain prognostic factors could be managed by surgical resection with long term survivals.
Annals of Surgery Vol 244(4), October 2006.
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