2005 Abstracts: Hepatic Resection for Non-Colorectal, Non-Neuroendocrine Metastases
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Hepatic Resection for Non-Colorectal, Non-Neuroendocrine Metastases
Fernando Cordera, Mayo Clinic, Rochester, MN
Hypothesis: Resection of certain hepatic metastases of non-colorectal, non-neuroendocrine (NCNNE) origin provides actual long-term (>5 years) survival.
Design: Retrospective outcome study. Setting: Single tertiary referral institution. Patients: Between 1/1988 and 10/1998, 64 consecutive patients had resection of hepatic metastases from NCNNE primary tumors. Main Outcome Measures: Overall and disease free survival were correlated to clinicopathologic factors, operative morbidity and mortality. Results: 13 patients underwent a right hepatectomy, 6 underwent a left hepatectomy, 3 had extended right and 2 an extended left hepatectomy, 2 patients had segmentectomy, 24 underwent wedge resections and 14 underwent a combination of these forms of resection. R0 resection was achieved in 56 patients (87.5%). The operative mortality was <2% (1 of 64). Actual 1-, 3-, and 5-year survivals were 81%, 43%, and 30%. The factor adversely associated with overall and disease free survival was uniformly related to the interval between primary tumor resection and the development of hepatic metastases. Conclusion: A <2% operative mortality and an actual 5-year survival of 30% justifies hepatic resection, including major hepatic resection, for certain NCNNE metastases. The factor affecting prognosis in this highly select group of patients was the biological behavior of the tumor, with tumors that metastasize earlier having poorer survival rates.
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