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01.12.2014 | Systematic Reviews and Meta-analyses

The benefits of liver resection for non-colorectal, non-neuroendocrine liver metastases: a systematic review

verfasst von: Timothy L. Fitzgerald, Jason Brinkley, Shannon Banks, Nasreen Vohra, Zachary P. Englert, Emmanuel E. Zervos

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 8/2014

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Abstract

Purpose

Defining the benefits of resection of isolated non-colorectal, non-neuroendocrine (NCRNNE) liver metastases is difficult. To better understand the survival benefit in this group of patients, we conducted a systematic review of the previous literature.

Methods

Medline, Web of Knowledge, and manual searches were performed using search terms, such as “liver resection” and “primary tumor.” Inclusion criteria were year > 1990, >five patients, and median survival reported or derived. An expected median survival was calculated from weighted averages of median survivals, and differences were assessed using a permutation test.

Results

A total of 7,857 references were identified. Overall 4,735 abstracts were reviewed; 120 manuscripts evaluated and of these, 73 met the study inclusion criteria. The final population consisted of 3,596 patients with renal (n = 234), ovarian (n = 119), testicular (n = 153), adrenal (n = 90), small bowel (n = 28), gallbladder (n = 21), duodenum (n = 38), gastric (n = 481), pancreatic (n = 55), esophageal (n = 23), head and neck (n = 15), and lung (n = 36) cancers, gastrointestinal stromal tumors (GISTs) (n = 106), cholangiocarcinoma (n = 13), sarcoma (n = 189), and melanoma (n = 643). The greatest expected median was 63 months for genitourinary (GU) primaries (n = 549; range 5.4–142 months) followed by 44.4 months for breast cancer (n = 1,013; range 8–74 months), 22.3 months for gastrointestinal cancer (n = 549; range 5–58 months), and 23.7 months for other tumor types (n = 1,082; range 10–72 months). Using a permutation test, we observed that survival was best for patients with GU primaries followed by that for breast cancer patients. Additionally, we also observed that survival was similar for those with cancer of the GI tract and other primary sites.

Conclusions

There appears to be a benefit to resection for patients with NCRNNE liver metastases. The degree of survival advantage is predicated by primary site.

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Titel: The benefits of liver resection for non-colorectal, non-neuroendocrine liver metastases: a systematic review
verfasst von: Timothy L. Fitzgerald
Jason Brinkley
Shannon Banks
Nasreen Vohra
Zachary P. Englert
Emmanuel E. Zervos
Publikationsdatum: 01.12.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Langenbeck's Archives of Surgery / Ausgabe 8/2014
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-014-1241-3

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Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

The benefits of liver resection for non-colorectal, non-neuroendocrine liver metastases: a systematic review

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Chirurgie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

Ureterstriktur: Innovative OP-Technik bewährt sich

Hochrisiko-Eingriffe für postoperative Übelkeit

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“