Survival of Patients With Noncolorectal Non-Neuroendocrine Liver Metastases: A Nationwide Cohort Study From the Danish Liver Cancer Group

Abstract

Introduction

Surgical treatment of noncolorectal, non-neuroendocrine liver metastases (NCNNLM) remains unclear. This nationwide study evaluated the outcome of patients with NCNNLM, evaluated at multidisciplinary team conferences and included in the Danish Liver Cancer Group Database, according to surgery or no surgery.

Methods

We identified all patients with NCNNLM evaluated at multidisciplinary team conferences at the four specialized centers in Denmark between October 2013 and November 2023. Patient characteristics and survival were analyzed using descriptive statistics and illustrated by Kaplan–Meier curves, respectively. Prognostic factors were assessed with logistic regression, Cox regression, and accelerated failure time models.

Results

605 patients were included in the analyses. The median follow-up was 20 mo, none were lost to follow-up. The median age of patients was 64 y, with a female predominance (58%). Most patients (93%) had World Health Organization (WHO) performance status 0-1. The overall 5-y survival rate was 29%, with a median survival of 27 mo. Surgery was performed in 307 patients (51%). Surgical intervention was associated with better survival compared with nonsurgical treatment (median survival 39 versus 13 mo, P < 0.05). Poor prognostic factors included age exceeding 64 y (hazard ratio = 1.022, P < 0.0001) and WHO performance status 2-4 (odds ratio 6.89, P = 0.007).

Conclusions

NCNNLM carries a poor prognosis. Surgery of liver metastasis is associated with improved survival with age, WHO performance status, and primary cancer type serving as important prognostic factors. However, from our study we could not establish a causal effect of surgery and confounding by indication is likely.