Leberresektion bei nicht kolorektalen, nicht neuroendokrinen Lebermetastasen – ist die Resektion im Rahmen des „onko-chirurgischen“ Therapiekonzeptes gerechtfertigt?

BACKGROUND: The value of hepatic resection for non-colorectal, non-neuroendocrine liver metastases remains controversial and is still under -debate. Although there are numerous reported cases, the results are inconsistent due to the het-ero-geneity of the enrolled patients. The aim of the present study was to determine the utility of liver resection in the long-term outcome of -pa-tients with non-colorectal, non-neuroendo-crine liver metastases and to define prognostic factors predicting long-term survivors. METHODS: The records of patients undergoing liver resection for non-colorectal, non-neuro-endo-crine liver metastases between January 1994 and December 2008 were analysed. Patient demograph-ics, tumour characteristics, type of -resection, long-term outcome and prognostic factors were analysed. RESULTS: Between 1994 and December 2008 273 liver resections were performed in 242 pa-tients because of non-colorectal, non-neuroendo-crine liver metastases. The morbidity rate was 20.9 % (n = 57), the mortality rate was 2.2 % (n = 6). Patient survival at 1, 3, 5 and 10 years was 76 %, 42 %, 28 % and 13 %, respectively. In multivariate analyses margin status (R0 vs. R2; p = 0.001) and time to metastases (synchronous vs. metach-ro-nous) were predictors of survival. Patient’s age, type of resection, number and size of metastases did not achieve significance. According to the -primary tumour site, patient survival differed. -Patients with urological and gynaecological primary tumours faired better whereas patients with liver metastases from gastrointestinal primary tumours did worse without reaching statistical significance. CONCLUSION: Liver resection for non-colorectal, non-neuroendocrine liver metastases is safe and effective. For individual patients with controlled systemic disease, liver resection can offer appropriate survival rates and should be a part of the onco-surgical treatment.

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