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Liver resection for metastatic soft tissue sarcomas

BACKGROUND: The objective of this study was to evaluate the surgical treatment of patients with liver metastasis of soft tissue sarcomas, with emphasis on the identification of prognostic factors and survival. METHODS: This is a retrospective analysis of liver resections for metastatic soft tissue sarcomas performed at National Institute of Cancer in Rio de Janeiro, between 1992 and 2002. Demographic factors, characteristics of the primary and metastatic tumors, disease free interval, type of liver resections, overall survival and disease free interval after liver resections were studied. Statistical analysis were performed with version 8 SPSS and EpiInfo 2002. RESULTS: In five patients the primary tumor was localized at the gastrointestinal tract, in four at the retroperitoneum, in one at the uterus and in one at the deltoid muscle. Ten of the tumors were leiomyosarcomas and one was a dermatofibrosarcoma. Six patients had G2 differentiation grade tumors and the other five had G3 tumors. Five patients underwent to segmentectomies, four to lobectomies and two to major hepatic resections. Two patients underwent to extra-hepatic associated resections. Complete resection was accomplished in seven patients. Multivariate analysis showed that overall survival was directly affected by complete resection with a 49-month survival for R0 resections compared to a 15-month survival for patients with residual disease (p<0.05). Similarly, patients with G2 tumors had a 49-month survival compared to a 15-month survival for patients with G3 tumors (p<0.0447). CONCLUSION: Liver resections for hepatic metastasis of soft tissue sarcomas can improve overall survival particularly for patients with complete resection (R0) and for low grade tumors.

Sarcoma; Soft Tissue Neoplasms; Hepatectomy; Metastases


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