HEPATIC RESECTION FOR NONCOLORECTAL, NONNEUROENDOCRINE METASTASES - A15-YEAR EXPERIENCE WITH 96 PATIENTS

Background. The rob of liver resection for hepatic metastases from non colorectal, nonneuroendocrine (NCNN) cancers is unknown. This study ex amines a large, single institutional experience of hepatic resection f or NCNN metastases. Methods. Records of 96 patients who underwent live r resection for metastatic NCNN cancer from 1980 to 1995 at a single i nstitution were reviewed. Survival after liver resection in this cohor t of patients is reported, and factors predictive of survival are anal yzed. Results. Resection was performed for liver metastases from genit ourinary primary tumors (n = 34), soft tissue primary tumors (n = 41), and metastases from other primary cancers (n = 21). Extent of liver r esection included wedge (n = 32), lobectomy (n = 44), and extended hep atic lobectomy (n = 20). No operative deaths occurred. Overall surviva l rate after resection at 1, 3, and 5 years was 80%, 45% and 37%, resp ectively (median survival, 32 months), with 12 actual 5-year survivors . There was no difference in survival according to the type of liver r esection, bilateral versus unilateral disease or resection of extrahep atic disease. Disease-free interval of less than. 36 months before dis covery of liver metastases, curative resection, and primary tumor grou p (genitourinary was greater than soft tissue, which was greater than gastrointestinal) were predictors of a significantly better survival b y multivariate analysis. Conclusions. Primary tumor type, disease-free interval, and curative resection predict those patients who benefit f rom hepatic resection. Hepatic resection for patients with NCNN metast asis has value in carefully selected patients.