A retrospective review from 4 major liver centers identified patients who underwent liver resection for noncolorectal non-neuroendocrine metastases between 1990 and 2009. The Kaplan-Meier method was used to analyze survival, and Cox regression models were used to examine prognostic variables.
There were 420 patients available for analysis. Breast cancer (n = 115; 27 % ) was the most common primary malignancy, followed by sarcoma (n = 98; 23 % ), and genitourinary cancers (n = 92; 22 % ). Crude postoperative morbidity and mortality rates were 20 % and 2 % , respectively. Overall median survival was 49 months, and 1, 3, and 5-year Kaplan-Meier survival rates were 73 % , 50 % , and 31 % . Survival was not significantly different between the various primary tumor types. Recurrent disease was found after hepatectomy in 66 % of patients. In multivariable models, lymphovascular invasion (p = 0.05) and metastases ? cm (p = 0.04) were independent predictors of poorer survival. Median survival was shorter for resections performed between 1990 and 1999 (n = 101, 32 months) when compared with resections between 2000 and 2009 (n = 319, 66 months; p = 0.003).
Hepatic metastasectomy for noncolorectal non-neuroendocrine cancers is safe and feasible in selected patients. Lymphovascular invasion and metastases ? cm were found to be associated with poorer survival. Patients undergoing metastasectomy in more recent years appear to be surviving longer, however, the reasons for this are not conclusively determined.