Results of a single-center experience with resection and ablation for sarcoma metastatic to the liver

Timothy M. Pawlik, Jean Nicolas Vauthey, Eddie K. Abdalla, Raphael E. Pollock, Lee M. Ellis, Steven A. Curley

Research output: Contribution to journalArticlepeer-review

Abstract

Hypothesis: A subset of patients with sarcoma liver metastasis may benefit from hepatic resection and/or ablation. Design: Retrospective review of prospectively collected cancer center database records. Patients and Methods: Sixty-six patients who underwent hepatic resection and/or open radiofrequency ablation of metastatic sarcoma between July 1, 1996, and April 30, 2005, were identified from the database. Clinicopathologic, operative, recurrence, and long-term survival data were analyzed. Results: The primary sarcoma site was the abdomen or retroperitoneum (n=22), stomach (n=18), small or large bowel (n=17), pelvis (n=4), uterus (n=3), or other (n=2). Tumor pathologic types included gastrointestinal stromal tumor (n=36), leiomyosarcoma (n=18), and sarcoma not otherwise classified (n=12). Thirty-five patients underwent resection, 18 underwent resection plus radiofrequency ablation, and 13 underwent radiofrequency ablation only. With a median follow-up of 35.8 months, 44 patients (66.7%) had recurrence (intrahepatic only, n=16; extrahepatic only, n=11; both, n=17). Treatment with radiofrequency ablation (either alone or combined with resection) (P=.002) and lack of adjuvant chemotherapy (P=.01) predicted shorter disease-free survival. The 1-, 3-, and 5-year overall survival rates were 91.2%, 65.4%, and 27.1%, respectively. Patients with gastrointestinal stromal tumor who were treated with adjuvant imatinib mesylate had the longest median survival (not reached) (P=.003). Conclusions: Long-term survival can be achieved following surgical treatment of sarcoma liver metastasis, especially in patients with gastrointestinal stromal tumor. Patients with sarcoma liver metastasis should be evaluated by a multidisciplinary team, as recurrence is common and adjuvant therapy may prolong survival.

Original languageEnglish (US)
Pages (from-to)537-543
Number of pages7
JournalArchives of Surgery
Volume141
Issue number6
DOIs
StatePublished - 2006
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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