Liver-directed surgery for metastatic squamous cell carcinoma to the liver

Results of a multi-center analysis

Timothy M. Pawlik, Ana Luiza Gleisner, Todd W. Bauer, Reid B. Adams, Srinevas K. Reddy, Bryan M. Clary, Robert C. Martin, Charles R. Scoggins, Kenneth K. Tanabe, James S. Michaelson, David A. Kooby, Charles A. Staley, Richard D. Schulick, Jean Nicolas Vauthey, Eddie K. Abdalla, Steven A. Curley, Michael A. Choti, Dominque Elias

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Background: The role of hepatic resection for metastatic squamous cell carcinoma (SCC) remains unknown. The current study evaluates the role of hepatic resection in patients with metastatic SCC to the liver. Methods: Between 1988 and 2006, 52 patients underwent hepatic resection of metastatic SCC at eight major cancer centers. Clinicopathologic factors were analyzed with regard to disease-free survival (DFS) and overall survival (OS). Results: Primary SCC site was anal (n = 27), head/neck (n = 12), lung (n = 4), esophagus (n = 2), and other (n = 7). Treatment of primary SCC was chemotherapy ± radiotherapy alone (n = 29), chemotherapy ± radiotherapy + surgery (n = 15), or surgery alone (n = 8). Forty-seven patients underwent resection alone, 2 resection + radiofrequency ablation (RFA), and 3 RFA only. At last follow-up, 33 (63.5%) patients had recurred. The median time to recurrence was 9.8 months, and 5-year DFS was 18.6%. Factors associated with reduced DFS were liver tumor size > 5 cm (hazard ratio (HR) = 2.02) and positive surgical margin (HR = 2.33). The overall median survival after hepatic resection was 22.3 months and 5-year actuarial OS was 20.5%. Risk factors associated with worse overall survival included synchronous disease (HR = 4.09), hepatic metastasis > 5 cm (HR = 1.71) and positive surgical resection margin (HR = 1.83). Conclusions: The majority of patients will recur following hepatic resection of SCC. Long-term survival, however, can be achieved following surgical resection of SCC liver metastasis, especially in patients who present with limited metachronous disease amenable to margin negative resection.

Original languageEnglish (US)
Pages (from-to)2807-2816
Number of pages10
JournalAnnals of Surgical Oncology
Volume14
Issue number10
DOIs
StatePublished - Oct 2007

Fingerprint

Squamous Cell Carcinoma
Liver
Survival
Disease-Free Survival
Radiotherapy
Neoplasm Metastasis
Drug Therapy
Esophagus
Neoplasms
Neck
Head
Recurrence
Lung
Margins of Excision

Keywords

  • Hepatic resection
  • Prognosis
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Pawlik, T. M., Gleisner, A. L., Bauer, T. W., Adams, R. B., Reddy, S. K., Clary, B. M., ... Elias, D. (2007). Liver-directed surgery for metastatic squamous cell carcinoma to the liver: Results of a multi-center analysis. Annals of Surgical Oncology, 14(10), 2807-2816. https://doi.org/10.1245/s10434-007-9467-8

Liver-directed surgery for metastatic squamous cell carcinoma to the liver : Results of a multi-center analysis. / Pawlik, Timothy M.; Gleisner, Ana Luiza; Bauer, Todd W.; Adams, Reid B.; Reddy, Srinevas K.; Clary, Bryan M.; Martin, Robert C.; Scoggins, Charles R.; Tanabe, Kenneth K.; Michaelson, James S.; Kooby, David A.; Staley, Charles A.; Schulick, Richard D.; Vauthey, Jean Nicolas; Abdalla, Eddie K.; Curley, Steven A.; Choti, Michael A.; Elias, Dominque.

In: Annals of Surgical Oncology, Vol. 14, No. 10, 10.2007, p. 2807-2816.

Research output: Contribution to journalArticle

Pawlik, TM, Gleisner, AL, Bauer, TW, Adams, RB, Reddy, SK, Clary, BM, Martin, RC, Scoggins, CR, Tanabe, KK, Michaelson, JS, Kooby, DA, Staley, CA, Schulick, RD, Vauthey, JN, Abdalla, EK, Curley, SA, Choti, MA & Elias, D 2007, 'Liver-directed surgery for metastatic squamous cell carcinoma to the liver: Results of a multi-center analysis', Annals of Surgical Oncology, vol. 14, no. 10, pp. 2807-2816. https://doi.org/10.1245/s10434-007-9467-8
Pawlik, Timothy M. ; Gleisner, Ana Luiza ; Bauer, Todd W. ; Adams, Reid B. ; Reddy, Srinevas K. ; Clary, Bryan M. ; Martin, Robert C. ; Scoggins, Charles R. ; Tanabe, Kenneth K. ; Michaelson, James S. ; Kooby, David A. ; Staley, Charles A. ; Schulick, Richard D. ; Vauthey, Jean Nicolas ; Abdalla, Eddie K. ; Curley, Steven A. ; Choti, Michael A. ; Elias, Dominque. / Liver-directed surgery for metastatic squamous cell carcinoma to the liver : Results of a multi-center analysis. In: Annals of Surgical Oncology. 2007 ; Vol. 14, No. 10. pp. 2807-2816.
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abstract = "Background: The role of hepatic resection for metastatic squamous cell carcinoma (SCC) remains unknown. The current study evaluates the role of hepatic resection in patients with metastatic SCC to the liver. Methods: Between 1988 and 2006, 52 patients underwent hepatic resection of metastatic SCC at eight major cancer centers. Clinicopathologic factors were analyzed with regard to disease-free survival (DFS) and overall survival (OS). Results: Primary SCC site was anal (n = 27), head/neck (n = 12), lung (n = 4), esophagus (n = 2), and other (n = 7). Treatment of primary SCC was chemotherapy ± radiotherapy alone (n = 29), chemotherapy ± radiotherapy + surgery (n = 15), or surgery alone (n = 8). Forty-seven patients underwent resection alone, 2 resection + radiofrequency ablation (RFA), and 3 RFA only. At last follow-up, 33 (63.5{\%}) patients had recurred. The median time to recurrence was 9.8 months, and 5-year DFS was 18.6{\%}. Factors associated with reduced DFS were liver tumor size > 5 cm (hazard ratio (HR) = 2.02) and positive surgical margin (HR = 2.33). The overall median survival after hepatic resection was 22.3 months and 5-year actuarial OS was 20.5{\%}. Risk factors associated with worse overall survival included synchronous disease (HR = 4.09), hepatic metastasis > 5 cm (HR = 1.71) and positive surgical resection margin (HR = 1.83). Conclusions: The majority of patients will recur following hepatic resection of SCC. Long-term survival, however, can be achieved following surgical resection of SCC liver metastasis, especially in patients who present with limited metachronous disease amenable to margin negative resection.",
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T1 - Liver-directed surgery for metastatic squamous cell carcinoma to the liver

T2 - Results of a multi-center analysis

AU - Pawlik, Timothy M.

AU - Gleisner, Ana Luiza

AU - Bauer, Todd W.

AU - Adams, Reid B.

AU - Reddy, Srinevas K.

AU - Clary, Bryan M.

AU - Martin, Robert C.

AU - Scoggins, Charles R.

AU - Tanabe, Kenneth K.

AU - Michaelson, James S.

AU - Kooby, David A.

AU - Staley, Charles A.

AU - Schulick, Richard D.

AU - Vauthey, Jean Nicolas

AU - Abdalla, Eddie K.

AU - Curley, Steven A.

AU - Choti, Michael A.

AU - Elias, Dominque

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N2 - Background: The role of hepatic resection for metastatic squamous cell carcinoma (SCC) remains unknown. The current study evaluates the role of hepatic resection in patients with metastatic SCC to the liver. Methods: Between 1988 and 2006, 52 patients underwent hepatic resection of metastatic SCC at eight major cancer centers. Clinicopathologic factors were analyzed with regard to disease-free survival (DFS) and overall survival (OS). Results: Primary SCC site was anal (n = 27), head/neck (n = 12), lung (n = 4), esophagus (n = 2), and other (n = 7). Treatment of primary SCC was chemotherapy ± radiotherapy alone (n = 29), chemotherapy ± radiotherapy + surgery (n = 15), or surgery alone (n = 8). Forty-seven patients underwent resection alone, 2 resection + radiofrequency ablation (RFA), and 3 RFA only. At last follow-up, 33 (63.5%) patients had recurred. The median time to recurrence was 9.8 months, and 5-year DFS was 18.6%. Factors associated with reduced DFS were liver tumor size > 5 cm (hazard ratio (HR) = 2.02) and positive surgical margin (HR = 2.33). The overall median survival after hepatic resection was 22.3 months and 5-year actuarial OS was 20.5%. Risk factors associated with worse overall survival included synchronous disease (HR = 4.09), hepatic metastasis > 5 cm (HR = 1.71) and positive surgical resection margin (HR = 1.83). Conclusions: The majority of patients will recur following hepatic resection of SCC. Long-term survival, however, can be achieved following surgical resection of SCC liver metastasis, especially in patients who present with limited metachronous disease amenable to margin negative resection.

AB - Background: The role of hepatic resection for metastatic squamous cell carcinoma (SCC) remains unknown. The current study evaluates the role of hepatic resection in patients with metastatic SCC to the liver. Methods: Between 1988 and 2006, 52 patients underwent hepatic resection of metastatic SCC at eight major cancer centers. Clinicopathologic factors were analyzed with regard to disease-free survival (DFS) and overall survival (OS). Results: Primary SCC site was anal (n = 27), head/neck (n = 12), lung (n = 4), esophagus (n = 2), and other (n = 7). Treatment of primary SCC was chemotherapy ± radiotherapy alone (n = 29), chemotherapy ± radiotherapy + surgery (n = 15), or surgery alone (n = 8). Forty-seven patients underwent resection alone, 2 resection + radiofrequency ablation (RFA), and 3 RFA only. At last follow-up, 33 (63.5%) patients had recurred. The median time to recurrence was 9.8 months, and 5-year DFS was 18.6%. Factors associated with reduced DFS were liver tumor size > 5 cm (hazard ratio (HR) = 2.02) and positive surgical margin (HR = 2.33). The overall median survival after hepatic resection was 22.3 months and 5-year actuarial OS was 20.5%. Risk factors associated with worse overall survival included synchronous disease (HR = 4.09), hepatic metastasis > 5 cm (HR = 1.71) and positive surgical resection margin (HR = 1.83). Conclusions: The majority of patients will recur following hepatic resection of SCC. Long-term survival, however, can be achieved following surgical resection of SCC liver metastasis, especially in patients who present with limited metachronous disease amenable to margin negative resection.

KW - Hepatic resection

KW - Prognosis

KW - Squamous cell carcinoma

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