Hepatic Metastases from Soft-Tissue Sarcoma

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Abstract
Hepatic metastases from soft-tissue sarcoma are evaluated to define treatment and its limitations. From 981 adult patients with diagnoses of soft-tissue sarcoma, 65 patients with hepatic metastases were studied. An intra-abdominal primary site was present in 61 of 65 patients, with 85% high-grade leiomyosarcoma. Hepatic resection was performed in 14 patients (22%). All patients have had recurrences after hepatic resection—11 of 14 in the liver—with a median survival of 30 months. Chemotherapy resulted in partial response in three patients and no complete responses. Survival is not influenced by grade, type, primary site, disease-free interval, chemotherapy, or hepatic resection. The uncommon response to conventional chemotherapy does not support its use in the treatment of hepatic metastases from soft-tissue sarcoma. Extent of disease limits the application and success of hepatic resection for soft-tissue sarcoma, and anything less than complete resection is not indicated.