Hepatectomy Enables Prolonged Survival in Select Patients with Isolated Noncolorectal Liver Metastasis

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Abstract
Objective This study was done to determine the benefit of undergoing liver resection for noncolorectal metastasis. Methods A single-institution retrospective review of all patients (n = 95) who underwent hepatic resection for a noncolorectal liver metastasis from 1990 to 2005 was performed. Primary outcomes measure was months of patient survival after liver resection. Results Median patient age was 58 years (range 19 to 83 years). There were 37 men (38.9%) and 58 women (61.1%). The 30-day postoperative mortality rate was 2.1%, and postoperative complications developed in 15.8% of patients. Mean hospital stay was 7 days (range 4 to 25 days). Median time of survival from date of liver resection was 36 months, and 5-year survival rate was 34.9%. Primary tumor sites were identified as foregut or gastrointestinal in 16.8% and nongastrointestinal in 83.2%. Patients with a nonforegut primary tumor had a median survival time twice as long as those with foregut primaries (49 months versus 20 months, p < 0.001). Multiple liver metastases were an independent prognostic factor for worse outcomes with a hazard ratio of 3.3 (p = 0.007). No treatment-dependent variables (initial treatment modality, extent of liver resection, margins, complications) were found on multivariable analysis to be important prognostic factors. Conclusions In select patients with any of a variety of malignancies metastatic to the liver, prolonged survival can result from liver resection, especially in those with a single, resectable tumor from a nongastrointestinal primary site.