Surgical tactic for non-colorectal and non-neuroendocrine liver metastases
Summary. The efficacy of surgical treatment of metastatic liver damage with non-colorectal cancer and non-neuroendocrine tumors (kidney, bladder, testicular, uterus and appendages, stomach, esophagus, small intestine, lung, skin melanoma) whose pathways of hematogenous metastasis are not limited to the system of portal vein, and spread with systemic blood flow stay still unknown. Aim. Perform a retrospective analysis of the efficacy and safety of liver resections in patients with non-colorectal and non-neuroendocrine metastases. Material and methods. We conducted a retrospective analysis of the results of combined treatment patients who had a metastatic liver injury during the history of the disease based on the National Cancer Registry database of the National Cancer Institute. Results. A retrospective study of 287 cases of surgical and combined treatment of cancer patients who had metastatic liver damage. The largest share of this cohort was made up of patients with oncogynecological origin of primary tumors (n=78; 27.2%), patients with breast cancer (n=72; 25.1%) and a group of patients with gastric cancer (n= 70; 24.4%). The least patients were in the oncourological group (n=29; 10.1%). We also analyzed the results of 38 (13.3%) resections of the liver, whose primary tumors had a different localization and histological structure, in particular, laryngeal, trachea, lung, tongue (others). The median of overall 5-year survival was: oncogynecological group — 86.52±0.0 months, others — 22.42±9.63 months, breast cancer group — 52.03±12.65 months, gastric cancer group — 0 months, oncourological group — 50.98±18.38 months. Conclusions. Resection of the liver in patients with non-neuroendocrine and non-colorectal tumors is appropriate and safe. Long-term results are morphologically dependent. Selection for resection of the liver in patients with non-neuroendocrine and non-colorectal tumors should include the evaluation of the effectiveness of systemic preoperative treatment, the status of the patient and the analysis of a multidisciplinary team in the specialized surgical centers.
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