Current status of liver surgery for non-colorectal non-neuroendocrine liver metastases: the NON.LI.MET. Italian Society for Endoscopic Surgery and New Technologies (SICE) and Association of Italian Surgeons in Europe (ACIE) collaborative international survey.

Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 101539818 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2038-3312 (Electronic) Linking ISSN: 2038131X NLM ISO Abbreviation: Updates Surg Subsets: MEDLINE

Original Publication: Milano : Springer-Verlag Italia

Liver Neoplasms* ; Laparoscopy*/methods ; Surgeons* ; Colorectal Neoplasms*/surgery; Humans ; Europe ; Surveys and Questionnaires ; Italy/epidemiology

Despite the increasing trend in liver resections for non-colorectal non-neuroendocrine liver metastases (NCNNLM), the role of surgery for these liver malignancies is still debated. Registries are an essential, reliable tool for assessing epidemiology, diagnosis, and therapeutic approach in a single hub, especially when data are dispersive and inconclusive, as in our case. The dissemination of this preliminary survey would allow us to understand if the creation of an International Registry is a viable option, while still offering a snapshot on this issue, investigating clinical practices worldwide. The steering committee designed an online questionnaire with Google Forms, which consisted of 37 questions, and was open from October 5th, 2022, to November 30th, 2022. It was disseminated using social media and mailing lists of the Italian Society of Endoscopic Surgery and New Technologies (SICE), the Association of Italian Surgeons in Europe (ACIE), and the Spanish Chapter of the American College of Surgeons (ACS). Overall, 141 surgeons (approximately 18% of the total invitations sent) from 27 countries on four continents participated in the survey. Most respondents worked in general surgery units (62%), performing less than 50 liver resections/year (57%). A multidisciplinary discussion was currently performed to validate surgical indications for NCNNLM in 96% of respondents. The most commonly adopted selection criteria were liver resectability, RECIST criteria, and absence of extrahepatic disease. Primary tumors were generally of gastrointestinal (42%), breast (31%), and pancreaticobiliary origin (13%). The most common interventions were parenchymal-sparing resections (51% of respondents) of metachronous metastases with an open approach. Major post-operative complications (Clavien-Dindo > 2) occurred in up to 20% of the procedures, according to 44% of respondents. A subset analysis of data from high-volume centers (> 100 cases/year) showed lower post-operative complications and better survival. The present survey shows that NCNNLM patients are frequently treated by surgeons in low-volume hospitals for liver surgery. Selection criteria are usually based on common sense. Liver resections are performed mainly with an open approach, possibly carrying a high burden of major post-operative complications. International guidelines and a specific consensus on this field are desirable, as well as strategies for collaboration between high-volume and low-volume centers. The present study can guide the elaboration of a multi-institutional document on the optimal pathway in the management of patients with NCNNLM.
(© 2023. Italian Society of Surgery (SIC).)

Rees M, Tekkis PP, Welsh FK, O’Rourke T, John TG (2008) Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: a multifactorial model of 929 patients. Ann Surg 247(1):125–135. (PMID: 10.1097/SLA.0b013e31815aa2c218156932)
Pavel M, O’Toole D, Costa F, Capdevila J, Gross D, Kianmanesh R et al (2016) ENETS Consensus Guidelines Update for the Management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site. Neuroendocrinology 103(2):172–185. (PMID: 10.1159/00044316726731013)
Eysenbach G (2004) Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res 6(3):e34. https://doi.org/10.2196/jmir.6.3.e34. (PMID: 10.2196/jmir.6.3.e34154717601550605)
Adam R, Chiche L, Aloia T, Elias D, Salmon R, Rivoire M, Jaeck D, Saric J, Le Treut YP, Belghiti J, Mantion G, Mentha G (2006) Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model. Ann Surg 244:524–535. https://doi.org/10.1097/01.sla.0000239036.46827.5f. (PMID: 10.1097/01.sla.0000239036.46827.5f169983611856551)
Fitzgerald TL, Brinkley J, Banks S, Vohra N, Englert ZP, Zervos EE (2014) The benefits of liver resection for non-colorectal, non-neuroendocrine liver metastases: a systematic review. Langenbecks Arch Surg 399(8):989–1000. (PMID: 10.1007/s00423-014-1241-325148767)
Labgaa I, Slankamenac K, Schadde E, Jibara G, Alshebeeb K, Mentha G et al (2018) Liver resection for metastases not of colorectal, neuroendocrine, sarcomatous, or ovarian (NCNSO) origin: a multicentric study. Am J Surg 215(1):125–130. (PMID: 10.1016/j.amjsurg.2017.09.03029061283)
Takemura N, Saiura A (2017) Role of surgical resection for non-colorectal non-neuroendocrine liver metastases. W J Hepatol 9(5):242–251. (PMID: 10.4254/wjh.v9.i5.242)
Aghayan DL, Kalinowski P, Kazaryan AM et al (2019) Laparoscopic liver resection for non-colorectal non-neuroendocrine metastases: perioperative and oncologic outcomes. World J Surg Onc 17:156. https://doi.org/10.1186/s12957-019-1700-y. (PMID: 10.1186/s12957-019-1700-y)
Groeschl RT, Nachmany I, Steel JL, Reddy SK, Glazer ES, de Jong MC et al (2012) Hepatectomy for noncolorectal non-neuroendocrine metastatic cancer: a multi-institutional analysis. J Am Coll Surg 214(5):769–777. (PMID: 10.1016/j.jamcollsurg.2011.12.04822425166)
Cipriani F, Rawashdeh M, Ahmed M, Armstrong T, Pearce NW, Abu HM (2015) Oncological outcomes of laparoscopic surgery of liver metastases: a single-centre experience. Updates Surg 67(2):185–191. (PMID: 10.1007/s13304-015-0308-126109140)
Elias D, de Albuquerque AC, Eggenspieler P, Plaud B, Ducreux M, Spielmann M, Theodore C, Bonvalot S, Lasser P (1998) Resection of liver metastases from a noncolorectal primary: indications and results based on 147 monocentric patients. J Am Coll Surg 187:487–493. https://doi.org/10.1016/S1072-7515(98)00225-7. (PMID: 10.1016/S1072-7515(98)00225-79809564)
Hoffmann K, Bulut S, Tekbas A, Hinz U, Büchler MW, Schemmer P (2015) Is hepatic resection for non-colorectal, non-neuroendocrine liver metastases justified? Ann Surg Oncol 22(Suppl 3):S1083–S1092. https://doi.org/10.1245/s10434-015-4775-x. (PMID: 10.1245/s10434-015-4775-x26242369)
Schiergens TS, Lüning J, Renz BW, Thomas M, Pratschke S, Feng H, Lee SM, Engel J, Rentsch M, Guba M, Werner J, Thasler WE (2016) Liver resection for non-colorectal non-neuroendocrine metastases: where do we stand today compared to colorectal cancer? J Gastrointest Surg 20(6):1163–1172. https://doi.org/10.1007/s11605-016-3115-1 . (Epub 2016 February 26th PMID: 26921025). (PMID: 10.1007/s11605-016-3115-126921025)
Sano K, Yamamoto M, Mimura T, Endo I, Nakamori S, Konishi M, Miyazaki M, Wakai T, Nagino M, Kubota K, Unno M, Sata N, Yamamoto J, Yamaue H, Takada T, Japanese Society of Hepato-Biliary-Pancreatic Surgery (2018) Outcomes of 1,639 hepatectomies for non-colorectal non-neuroendocrine liver metastases: a multicenter analysis. J Hepatobiliary Pancreat Sci 25(11):465–475. https://doi.org/10.1002/jhbp.587 . (Epub 2018 November 20th. PMID: 30311741). (PMID: 10.1002/jhbp.58730311741)
Berardi G, Van Cleven S, Fretland AA, Barkhatov L, Halls M, Cipriani F et al (2017) Evolution of laparoscopic liver surgery from innovation to implementation to mastery: perioperative and oncologic outcomes of 2,238 patients from 4 European specialized centers. J Am Coll Surg 225(5):639–649. (PMID: 10.1016/j.jamcollsurg.2017.08.00628838869)
Liu R, Wakabayashi G, Kim HJ, Choi GH, Yiengpruksawan A, Fong Y, He J, Boggi U, Troisi RI, Efanov M, Azoulay D, Panaro F, Pessaux P, Wang XY, Zhu JY, Zhang SG, Sun CD, Wu Z, Tao KS, Yang KH, Fan J, Chen XP (2019) International consensus statement on robotic hepatectomy surgery in 2018. World J Gastroenterol 25(12):1432–1444. https://doi.org/10.3748/wjg.v25.i12.1432 . (PMID: 30948907; PMCID: PMC6441912). (PMID: 10.3748/wjg.v25.i12.1432309489076441912)
Becker F, Morgül H, Katou S, Juratli M, Hölzen JP, Pascher A, Struecker B (2021) Robotic liver surgery—current standards and future perspectives. Z Gastroenterol 59(1):56–62. https://doi.org/10.1055/a-1329-3067 . (Epub 2021 Jan 11. PMID: 33429451). (PMID: 10.1055/a-1329-306733429451)
Harrison LE, Brennan MF, Newman E, Fortner JG, Picardo A, Blumgart LH, Fong Y (1997) Hepatic resection for noncolorectal, nonneuroendocrine metastases: a fifteen-year experience with ninety-six patients. Surgery 121:625–632. https://doi.org/10.1016/S0039-6060(97)90050-7. (PMID: 10.1016/S0039-6060(97)90050-79186462)
Shih TH, Fan X (2009) Comparing response rates in email and paper surveys: a meta-analysis. Educ Res Rev 4:26–40. (PMID: 10.1016/j.edurev.2008.01.003)
Johnson TP (2012) Response rates and nonresponse errors in surveys. JAMA 307:1805–1806. (PMID: 10.1001/jama.2012.353222550194)

Investigator: M Guerrieri; F Agresta; D Cuccurullo; A Sartori; G D'Ambrosio; G Anania; A Agrusa; ME Allaix; A Balla; E Botteri; U Bracale; G Ceccarelli; M Milone; G Moretto; I Muttillo; N Perrotta; F Pirozzi; M Ortenzi; A Ioannidis; G Stavrou; N Gica; E Benzoni; F Rosa; V Visag-Castillo; SS Award; N Machairas; MM Manrique; M Marino; G De Nobili; L Sira-Gusa; A Iossa; M de Santibanes; G Lisi; A De Luca; A Giuliani; T Perra; A Porcu; N Cillara; A Giordano; ZL Laureiro; MV Papa; M Clementi; N Tamini; K Soreide; G Mazzarella; L Pio; C Dopazo; G Argenio; M An-Nechiarico; J Andreuccetti; MP Calvo; N Cinardi; R Angelico; GA Nari; E Saldino; C Gazia; B Anis; GM Machian; I Romic; J Bellido-Luque; S Pandanapoyana; F Roscio; GC Pattaccini; G Frazzetta; R Lim; A- Delvecchio; F Primavesi; M Rodrigeuz-Lopez; G Formisano; D Delogu; S Di Saverio; M Umar; S Elisa; C Del Basso; A d'Alessandro; GBL Sandri; MP Menna; B De Simone; I Al-Najami; G Curro; J Hila; S Quaresima; M Cervellera; J Sanberg; G Cestaro; M Capuano; M Ammendola; E Pinotti; G Palomba; V Tonini; GL Baiocchi; F Saraceno; G Calini; I Reccia; BV Dasari; G Poillucci; A Frontali; M Marconi; E Bertilone; E Basile; MG Toneto; D Coletta; AB Cacciaguerra; M Umar Younis; DA Merlini; A Julianov; NL Harish; L Morelli; M Marone; D Lo Conte; S D'Ugo; F D'Acapito; A Saroglu; R Santambrogio; M Giuffrida; N Furbetta; V Lopez-Lopez; A Panyko; F Romano; GAA Murillo; M Spartalis; E Spartalis; A Castaldi; PS Koh; JK Koong; MJC Santiago; GL Grazi; G Martinez-Mier; G Stavrou; AA Beatriz; I Gkekas; O Ioannidis; SAW Lujan; VJÉN Carneros; F Madrid; P Baroffio; A- Rashid; O Irkorucu; EPÑA Ros; S Pérez-Bertólez; D Schizas; GM Machain; Y Altinel; M Veroux; D Corallino; D Lorenzin; I Negoi; M Barabi-No; M Piccino; U Grossi; ÁJG Fernández; S Saeidi; S Maritato; G Picco-Lo; M Serradilla-Martín; G Esposito; F Albanesi; J Lammel-Lindemann
Keywords: Liver metastases; Liver resection; Liver surgery; Non-colorectal non-neuroendocrine liver metastases

Date Created: 20231024 Date Completed: 20240124 Latest Revision: 20240124

20240124

10.1007/s13304-023-01649-7

37875725