Non-colorectal non-neuroendocrine liver metastasis: a narrative review of surgical treatment.

BACKGROUND AND

OBJECTIVE

The liver is the main site of metastatic disease, and cancer metastases remain the main limit to successfully managing the malignant disease. Liver resection (LR) for the treatment of metastatic cancer has been described for over a hundred years and is widely accepted. The role of surgery in managing non-colorectal non-neuroendocrine liver metastasis (NCNNLM), evidence is still lacking due to different factors: the paucity of cases, the wide variety of histological subtypes of the primary disease and its biological behavior, and the absence of prospective studies.

METHODS

We performed a narrative review of peer-reviewed articles related to the surgical outcomes of NCNNLM. The aim of this review is determining the utility of surgery in NCNNLM, with attention to minimal invasive LRs. We analyzed the role of LR for NCNNLM according to the different cancers: digestive and non digestive.

KEY CONTENT AND FINDINGS: NCNNLM encompass a huge spectrum of histologic appearances. LR for limited NCNNLM may offer a curative option, but liver recurrence occurs frequently. Our ability to significantly predict the outcome is poor.

CONCLUSIONS

The cytotoxic chemotherapy and biologic agents have significantly altered the surgical treatment of LM. The latter treatments can convert inoperable patients into operable ones, with a clear relationship between the degree of resectability in patients judged inoperable at referral and the rate of response to the treatment scheme.