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De-Armas-Conde N, Ramon-Rodriguez J, Prada-Villaverde A, Jaén-Torrejimeno I, López-Guerra D, Blanco-Fernández G. Influence of the tumor site and histopathology after resection for non-colorectal non-neuroendocrine liver metastases. A single center experience. Cir Esp 2022:S2173-5077(22)00091-6. [PMID: 35500759 DOI: 10.1016/j.cireng.2022.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 04/15/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION It remains unclear whether liver resection is justified in patients with non-colorectal non-neuroendocrine liver metastases (NCNNLM). A single-center study was conducted to analyse overall survival (OS), disease-free survival (DFS), and potential prognostic factors in patients with different types of NCNNLM. METHOD A retrospective analysis of all patients who underwent liver resection of NCNNLM from January 2006 to July 2019 was performed. RESULTS A total of 62 patients were analyzed. 82.3% presented metachronous metastases and 74.2% were unilobar. The most frequent primary tumor site (PTS) were breast (24.2%), urinary tract (19.4%), melanoma (12.9%), and pancreas (9.7%). The most frequent primary tumor pathologies were breast carcinoma (24.2%), non-breast adenocarcinoma (21%), melanoma (12.9%) and sarcoma (12.9%). The most frequent surgical procedure performed was minor hepatectomy (72.6%). R0 resection was achieved in 79.5% of cases. The major complications' rate was 9.7% with a 90-day mortality rate of 1.6%. The 1, 3 and 5-year OS/DFS rate were 65%/28%, 45%/36% and 46%/28%, respectively. We identified the response to neoadjuvant therapy and PTS as possible prognostic factors for OS (P =0.06) and DFS (P =0.06) respectively. CONCLUSION Based on the results of our series, NCNNLM resection produces beneficial outcomes in terms of OS and DFS. PTS and the response to neoadjuvant therapy could be the main prognostic factors after resection.
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Affiliation(s)
- Noelia De-Armas-Conde
- Unidad de Cirugía HPB y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | - Julen Ramon-Rodriguez
- Unidad de Cirugía HPB y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | - Aranzazu Prada-Villaverde
- Unidad de Cirugía HPB y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | - Isabel Jaén-Torrejimeno
- Unidad de Cirugía HPB y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | - Diego López-Guerra
- Unidad de Cirugía HPB y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain; Facultad de Medicina, Universidad de Extremadura, Badajoz, Spain
| | - Gerardo Blanco-Fernández
- Unidad de Cirugía HPB y Trasplante Hepático, Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain; Facultad de Medicina, Universidad de Extremadura, Badajoz, Spain.
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Pipa-Muñiz M, Castells L, Pascual S, Fernández-Castroagudín J, Díez-Miranda I, Irurzun J, Díaz-Beveridge R, Senosiaín M, Arenas J, de la Mata M, Turnes J, Monge-Romero MI, Pérez-Enguix D, Bustamante-Schneider J, Otegui N, Molina-Pérez E, Rodríguez-Menéndez JE, Varela M. The ART-SCORE is not an effective tool for optimizing patient selection for DEB-TACE retreatment. A multicentre Spanish study. Gastroenterol Hepatol 2017; 40:515-524. [PMID: 28676199 DOI: 10.1016/j.gastrohep.2017.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/08/2017] [Accepted: 05/23/2017] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The appropriate selection of hepatocellular carcinoma (HCC) patients who are eligible for transarterial chemoembolization (TACE) remains a challenge. The ART score has recently been proposed as a method of identifying patients who are eligible or not for a second TACE procedure. OBJECTIVE To assess the validity of the Assessment for Retreatment with TACE (ART) score in a cohort of patients treated with drug-eluting bead TACE (DEB-TACE). SECONDARY OBJECTIVE to identify clinical determinants associated with overall survival (OS). METHOD A retrospective, multicentre study conducted in Spain in patients with HCC having undergone two or more DEB-TACE procedures between January 2009 and December 2014. The clinical characteristics and OS from the day before the second DEB-TACE of patients with a high ART score (ART≥2.5) and a low ART score (ART 0-1) were compared. Risk factors for mortality were identified using Cox's proportional hazards model. RESULTS Of the 102 patients included, 51 scored 0-1.5 and 51 scored ≥2.5. Hepatitis C was more frequent in patients scoring ≥2.5. Median OS from the day before the second DEB-TACE was 21 months (95% CI, 15-28) in the group scoring 0-1.5, and 17 months (95% CI, 10-25) in the group scoring ≥2.5 (P=0.3562). Platelet count and tumour size, but not the ART score, were independent baseline predictors of OS. CONCLUSIONS The ART score is not suitable for guiding DEB-TACE retreatment according to Spanish clinical practice standards.
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Affiliation(s)
- Maria Pipa-Muñiz
- Department of Gastroenterology and Hepatology, Hospital de Cabueñes, Gijón, Asturias, Spain
| | - Lluis Castells
- Liver Unit, Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Sonia Pascual
- Liver Unit, Digestive Department, Ciberehd, Hospital General Universitario de Alicante, Alicante,, Spain
| | | | - Iratxe Díez-Miranda
- Interventional Radiology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Javier Irurzun
- Interventional and Vascular Radiological Unit, Hospital General Universitario de Alicante, Alicante, Spain
| | | | - María Senosiaín
- Digestive Department, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain
| | - Juan Arenas
- Gastroenterology and Hepatology Department, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain
| | - Manuel de la Mata
- Unit of Hepatology and Liver Transplantation, CIBERehd, IMIBIC, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Juan Turnes
- Department of Gastroenterology, Complejo Hospitalario Universitario de Pontevedra, Instituto de Investigación Sanitaria Galicia Sur, Pontevedra, Spain
| | | | - Daniel Pérez-Enguix
- Interventional Radiology, Medical Imaging Clinical Area, Hospital Universitari i Policlínic La Fe, Valencia, Spain
| | | | - Nora Otegui
- Gastroenterology and Hepatology Department, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, Spain
| | - Esther Molina-Pérez
- Gastroenterology Department, Hospital Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | | | - Maria Varela
- Liver Unit, Department of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
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