비대장성 및 비내분비성암의 간전이시 간절제술의 임상적 고찰

Clinical Results of Hepatic Resection for Metastatic Noncolorectal Nonneuroendocrine Tumor

Purpose: Hepatic resection has been proven to be an effective therapy for metastatic colorectal carcinoma and it is a beneficial therapy for metastatic neuroendocrine tumors. Yet the role and efficacy of hepatic resection for metastatic noncolorectal nonneuroendocrine (NCNN) carcinoma have not yet been well defined. We evaluated the outcome and the prognostic factors of patients who are undergoing hepatic resection for metastases from NCNN carcinoma. Materials and Methods: The records of 46 patients who underwent liver resection for NCNN metastasis from Oct. 1992 to May 2006 were analyzed. Among the 46 patients, 26 patients were excluded due to direct hepatic invasion from stomach cancer. The patient demographics, tumor characteristics, the treatment and the postoperative survival rate were analyzed. Results: The median patient age was 54.9 years (range: 36-69 years) and there were 13 men (85.7%) and 7 women (15.3%). The mean survival time from the date of liver resection was $48{\pm}7.85$ months, and the 5-year survival rate was 33.7%. The primary tumor sites were identified as gastrointestinal in 60% of the patients and non-gastrointestinal in 40% of the patients. Patients with a gastrointestinal primary tumor had a median survival time that was similar to that of patients with non-gastrointestinal primary tumor (48 months versus 42 months, respectively, p=0.847). The number of liver metastases was an independent prognostic factor (p=0.030). Conclusions: In selected patients with NCNN liver metastasis, hepatic resection is an effective management and it can also prolong survival. Hepatic resection should be considered if lymphatic invasion and metastasis of the other organ are excluded.