Analysis of long-term results after liver surgery for metastases from colorectal and non-colorectal tumors: A retrospective cohort study. (June 2016) - Parisi, Amilcare
Abstract: Background: During the last decade, criteria for liver resection were extended thanks to surgical and oncological developments, thus increasing the number of surgeries for non-colorectal liver metastases. However, the real advantages of surgery in this category of patients remain debated, due to the few studies available in the literature. The present study aims to analyze liver surgery performed for metastatic disease at a single referral center, comparing outcomes of patients that underwent resections for colorectal and non-colorectal metastases. Methods: The overall study period was January 2005–May 2015. A total of 170 patients were selected from the institutional database and then included in the analysis. Patients and tumors characteristics were reported. Overall survival and subgroup analyses based on different primary malignancies were performed. The Kaplan-Meier method was used. Results: The mean age of the patients was 67.68 ± 10.98 years. Primary malignancies distribution resulted as follows: colorectal (77.1%), genitourinary (7.6%), neuroendocrine (5.3%), breast (4.7%), foregut (2.9%), melanoma (2.4%). The overall survival rates at 1, 3, 5 years, were 96.2%, 42.8% and 14.7%, respectively. The survival analysis showed a mean overall survival of 54 months in the colorectal metastases group vs 32 months in the non-colorectal liver metastases group (HR = 5.92, P = 0.015). Conclusion: Surgery for patients with non-colorectal liver metastases must be considered in the context of a multidisciplinary treatment where chemotherapy plays the main role. International guidelines and a specific consensus on this field are desirable to offer the best available therapy for the metastatic liver disease. Ethics and dissemination: This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevant laws/regulations. Trial registration number: researchregistry898. Highlights: Liver resections for metastases has been developed in last years. Selected patients with non-colorectal metastases can benefit from surgery. A multidisciplinary therapy is required and new guidelines are awaited.