The role of surgery in the management of liver metastases from non-colorectal cancers: A review of the literature

Surgery for non-colorectal liver metastases is nowadays indicated due to advances in surgical techniques and patients multimodal management. The objective of our study is to evaluate the surgical management of liver metastases of non-colorectal cancers in the visceral surgery department of the Mohamed V military hospital in Rabat.
This is a retrospective study on a series of 13 resections for non-colorectal liver metastases over a period of 6 years from January 2015 to December 2020.
In our series, the average age is 53 years with a prevalence of women (62%). The primary cancer was ducal breast carcinoma 6 times (46.15%). There were 2 cases of stromal tumors (15.38%), 2 cases of neuroendocrine tumors (15.38%), one case of gastric adenocarcinoma, gastric small cell lymphoma, and of adrenocortical carcinoma. Liver metastases were synchronous in 76.92% of cases, metachronous in 23.08% of cases. They were unique in 84.62% of cases, bilobar in 15.38% of cases. The type of liver resection performed was 11 metastasectomy, 3 segmentectomy, 3 bi-segmentectomy.  Mortality rate was zero and the morbidity rate was 15.38%. One patient had hepatic recurrence. With a follow-up of 3 to 36 months after resection, only one patient died after 12 months.
The management of patients with non-colorectal liver metastases is based on a multimodal approach. Our results show that surgery, when feasible in selected patients, is a safe option and the only possibility for long-term survival. Future advances in chemotherapy, biotherapies and immunotherapy are likely to broaden the indications for surgery.