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Partial hepatectomy for liver metastases from nasopharyngeal carcinoma: a comparative study and review of the literature.

Huang J, Li Q, Zheng Y, Shen J, Li B, Zou R, Wang J, Yuan Y - BMC Cancer (2014)

Bottom Line: Clinicopathological data and treatment outcomes were compared retrospectively.No significant differences were observed between the two groups in terms of the clinicopathological features, which include gender ratio, liver function, accompanying cirrhosis, rate of infection with the hepatitis B virus, tumor size, tumor number, pathological type and preoperative comorbidities.Thus far, 5 patients have survived for more than 5 years, and the longest survival time is 168.1 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Rd, E,, Guangzhou, Guangdong 510060, China. yuanyf@mail.sysu.edu.cn.

ABSTRACT

Background: The management of liver metastases from nasopharyngeal carcinoma (NPC) has not been extensively investigated. This study aimed to compare the long-term outcome of patients with liver metastases from NPC who were treated by a partial hepatectomy or transcatheter hepatic artery chemoembolization (TACE).

Methods: Between January 1993 and December 2010, 830 patients were diagnosed with liver metastases from NPC and exhibited a complete response to the primary cancer of the nasopharynx and regional lymph nodes. Fifteen patients with intrahepatic metastasis underwent R0 partial hepatectomy. As a parallel control group, another 15 patients with a resectable liver metastasis who underwent TACE were selected. Prior to the resection and TACE that were performed on patients in these two groups, radical radiotherapy with or without adjuvant chemotherapy was administered. Clinicopathological data and treatment outcomes were compared retrospectively.

Results: No significant differences were observed between the two groups in terms of the clinicopathological features, which include gender ratio, liver function, accompanying cirrhosis, rate of infection with the hepatitis B virus, tumor size, tumor number, pathological type and preoperative comorbidities. The 1-, 3- and 5-year overall survival rates from the time of hepatectomy were 85.7%, 64.2% and 40.2%, respectively, with a median survival of 45.2 months, whereas the 1-, 3- and 5-year overall survival rates were 53.3%, 26.6% and 20.0% for patients in the control group (P = 0.039), respectively, with a median survival of 14.1 months. The actuarial median progression-free survival (PFS) of the patients in the resection group was 21.2 months, and the 1-, 3- and 5-year PFS rates were 70%, 53% and 18%, respectively. In the control group, the 1-, 3- and 5-year PFS rates were 27%, 7% and 0.0% (P = 0.007), respectively, with a median survival of 4.2 months. Thus far, 5 patients have survived for more than 5 years, and the longest survival time is 168.1 months.

Conclusions: For patients with limited liver metastases from NPC, hepatectomy provides a survival advantage over TACE. Due to the limited treatment options for patients with liver metastasis from NPC, hepatectomy should be recommended as an optimal treatment. Moreover, perioperative chemotherapy may be associated with an improved prognosis.

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The Kaplan–Meier survival analysis of the progression-free survival of the 15 patients with hepatic metastases from NPC who underwent resection and the 15 patients who underwent transhepatic arterial chemoembolization.
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Fig2: The Kaplan–Meier survival analysis of the progression-free survival of the 15 patients with hepatic metastases from NPC who underwent resection and the 15 patients who underwent transhepatic arterial chemoembolization.

Mentions: A total of 11 patients in the resection group demonstrated a progression of the disease after partial hepatectomy, while 2 of the 4 patients without progression survived 168.1 and 13.0 months, respectively; the other 2 patients were censored because of lost follow-up. However, in the control group, 15 patients had tumor progression after TACE with one lost follow-up. The median OS time after hepatectomy was 45.2 months (range: 0.6 to 168.1 months), and the median OS time of the control group was 14.1 months (range: 2.1 to 95.2 months). Five patients in the resection group survived more than 5 years, including one 10-year survivor. The median PFS of the two groups was 21.2 months for patients in the resection group (range: 0.6 to 168.1 months) and 4.16 months for patients in the control group (range: 0.7 to 38.1 months). The OS rates for 1, 3, and 5 years after resection were 85.7%, 64.1%, and 40.2% for patients in the resection group, and 53.3%, 26.6%, and 20.0% for patients in the control group (Table 4). The postoperative long-term OS of the patients in the resection group was significantly better than that of patients in the control group (P = 0.039; Figure 1). When stratified by different resection methods, 11 patients underwent major resections with a median OS of 56.0 ± 13.2 months, and 4 patients with minor resections only had a median OS of 10.7 ± 3.7 months (P = 0.036). The PFS at 1, 3, and 5 years was 70.0%, 53.0%, and 18.0% for patients in the resection group and 27.0%, 7.0%, and 0.0% for patients in the control group (P = 0.007; Figure 2). The postoperative progression-free survival of patients in the resection group was significantly better than that of patients in the control group (P = 0.007; Figure 2).Table 4


Partial hepatectomy for liver metastases from nasopharyngeal carcinoma: a comparative study and review of the literature.

Huang J, Li Q, Zheng Y, Shen J, Li B, Zou R, Wang J, Yuan Y - BMC Cancer (2014)

The Kaplan–Meier survival analysis of the progression-free survival of the 15 patients with hepatic metastases from NPC who underwent resection and the 15 patients who underwent transhepatic arterial chemoembolization.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4233067&req=5

Fig2: The Kaplan–Meier survival analysis of the progression-free survival of the 15 patients with hepatic metastases from NPC who underwent resection and the 15 patients who underwent transhepatic arterial chemoembolization.
Mentions: A total of 11 patients in the resection group demonstrated a progression of the disease after partial hepatectomy, while 2 of the 4 patients without progression survived 168.1 and 13.0 months, respectively; the other 2 patients were censored because of lost follow-up. However, in the control group, 15 patients had tumor progression after TACE with one lost follow-up. The median OS time after hepatectomy was 45.2 months (range: 0.6 to 168.1 months), and the median OS time of the control group was 14.1 months (range: 2.1 to 95.2 months). Five patients in the resection group survived more than 5 years, including one 10-year survivor. The median PFS of the two groups was 21.2 months for patients in the resection group (range: 0.6 to 168.1 months) and 4.16 months for patients in the control group (range: 0.7 to 38.1 months). The OS rates for 1, 3, and 5 years after resection were 85.7%, 64.1%, and 40.2% for patients in the resection group, and 53.3%, 26.6%, and 20.0% for patients in the control group (Table 4). The postoperative long-term OS of the patients in the resection group was significantly better than that of patients in the control group (P = 0.039; Figure 1). When stratified by different resection methods, 11 patients underwent major resections with a median OS of 56.0 ± 13.2 months, and 4 patients with minor resections only had a median OS of 10.7 ± 3.7 months (P = 0.036). The PFS at 1, 3, and 5 years was 70.0%, 53.0%, and 18.0% for patients in the resection group and 27.0%, 7.0%, and 0.0% for patients in the control group (P = 0.007; Figure 2). The postoperative progression-free survival of patients in the resection group was significantly better than that of patients in the control group (P = 0.007; Figure 2).Table 4

Bottom Line: Clinicopathological data and treatment outcomes were compared retrospectively.No significant differences were observed between the two groups in terms of the clinicopathological features, which include gender ratio, liver function, accompanying cirrhosis, rate of infection with the hepatitis B virus, tumor size, tumor number, pathological type and preoperative comorbidities.Thus far, 5 patients have survived for more than 5 years, and the longest survival time is 168.1 months.

View Article: PubMed Central - PubMed

Affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, 651 Dongfeng Rd, E,, Guangzhou, Guangdong 510060, China. yuanyf@mail.sysu.edu.cn.

ABSTRACT

Background: The management of liver metastases from nasopharyngeal carcinoma (NPC) has not been extensively investigated. This study aimed to compare the long-term outcome of patients with liver metastases from NPC who were treated by a partial hepatectomy or transcatheter hepatic artery chemoembolization (TACE).

Methods: Between January 1993 and December 2010, 830 patients were diagnosed with liver metastases from NPC and exhibited a complete response to the primary cancer of the nasopharynx and regional lymph nodes. Fifteen patients with intrahepatic metastasis underwent R0 partial hepatectomy. As a parallel control group, another 15 patients with a resectable liver metastasis who underwent TACE were selected. Prior to the resection and TACE that were performed on patients in these two groups, radical radiotherapy with or without adjuvant chemotherapy was administered. Clinicopathological data and treatment outcomes were compared retrospectively.

Results: No significant differences were observed between the two groups in terms of the clinicopathological features, which include gender ratio, liver function, accompanying cirrhosis, rate of infection with the hepatitis B virus, tumor size, tumor number, pathological type and preoperative comorbidities. The 1-, 3- and 5-year overall survival rates from the time of hepatectomy were 85.7%, 64.2% and 40.2%, respectively, with a median survival of 45.2 months, whereas the 1-, 3- and 5-year overall survival rates were 53.3%, 26.6% and 20.0% for patients in the control group (P = 0.039), respectively, with a median survival of 14.1 months. The actuarial median progression-free survival (PFS) of the patients in the resection group was 21.2 months, and the 1-, 3- and 5-year PFS rates were 70%, 53% and 18%, respectively. In the control group, the 1-, 3- and 5-year PFS rates were 27%, 7% and 0.0% (P = 0.007), respectively, with a median survival of 4.2 months. Thus far, 5 patients have survived for more than 5 years, and the longest survival time is 168.1 months.

Conclusions: For patients with limited liver metastases from NPC, hepatectomy provides a survival advantage over TACE. Due to the limited treatment options for patients with liver metastasis from NPC, hepatectomy should be recommended as an optimal treatment. Moreover, perioperative chemotherapy may be associated with an improved prognosis.

Show MeSH
Related in: MedlinePlus