Long-term Survivors After Liver Resection for Ovarian Cancer Liver Metastases

Ovarian cancer is one of the most aggressive gynecological malignancies and most patients are diagnosed at an advanced stage of disease. In these cases, the best therapeutic approach in order to provide good control remains an aggressive surgical approach leading to complete R0 resection. The experience provided by performing liver resection for colorectal hepatic metastases in association with the observation that residual disease remains the most important prognostic factor in ovarian cancer encouraged surgeons worldwide to include hepatic resection as part of the therapeutic armamentarium in ovarian cancer liver metastases. Patients and Methods: Data of patients submitted to liver resection for ovarian cancer liver metastases were retrospectively reviewed. The main inclusion criterion for the current study was a reported survival greater than 5 years after hepatic resection. Results: Eight patients were eligible for study inclusion: four cases were submitted to liver resection during primary cytoreduction, two cases were submitted to liver resection as part of secondary cytoreduction while the other two cases underwent hepatic resection at the moment of tertiary cytoreduction. In all cases R0 resection was achieved. Postoperatively one patient developed an abdominal abscess requiring for percutaneous drainage and one patient developed a hemoperitoneum necessitating re-operation. The mean overall survival was 123 months for patients submitted to liver resection as part of primary cytoreduction; patients submitted to liver resection as part of secondary cytoreduction experienced an overall survival of 66 and 73 months, respectively, while patients submitted to liver resection as part of tertiary cytoreductive surgery are alive at 5-year follow-up. Conclusion: In selected cases liver resection for ovarian cancer liver metastases can be associated with a significant increase of the overall survival.