Hepatic resection of noncolorectal nonneuroendocrine metastases

Because hepatic resection is generally a safe procedure, the indications fo r resection of noncolorectal nonneuroendocrine (NCNNE) hepatic metastases h ave broadened, The prognostic features of NCNNE metastases treated surgical ly were reviewed to define better the value of resection, A retrospective r eview of patients undergoing liver resection for NCNNE metastases between 1 978 and 1998 was undertaken. Thirty-seven patients were identified. Mean ag e was 56 years, with a median follow-up of 22 months. Primary tumor sites w ere grouped into gastrointestinal (GI) adenocarcinoma (small bowel, n = 4; pancreas, n = 2; esophagus, n = 1) and other (renal cell, n = 7; sarcoma, n = 7; melanoma, n = 5; adrenal, 3; unknown adenocarcinoma, n = 3; thyroid, n = 2; testicular, n = 1; ovarian, n = 1; breast, n = 1). All patients unde rwent surgery for cure, Metastases were synchronous in 14 patients. There w as no surgical mortality, Overall 5-year survival rate was 45%, Five-year s urvival rates were better for patients with non-GI-origin metastases (60% v 0%; P = .01). Long-term survival was seen only in patients with non-GI-ori gin metastases. The extent of resection, presence of synchronous metastases , or disease-free interval from time of original disease to presentation wi th liver metastases were not predictive of outcome. We conclude that patien ts with NCNNE hepatic metastases can undergo liver resection with an expect ation of prolonged survival. However, patients with liver metastases from G I primary tumors other than time colorectum are unlikely to show extended s urvival. Copyright (C) 2000 by the American Association far the Study of Li ver Diseases.