Hepatic resection for parenchimatous lesions as part of primary cytoreduction for advanced stage epithelial ovarian cancer

Aims: To evaluate the role of surgical resection for parenchimatous liver metastases from ovarian cancer at the moment of primary cytoreduction. Method: At the moment of primary cytoreduction, seven patients with ovarian cancer liver metastases were submitted to hepatic resections in Fundeni Clinical Hospital between January 2002 – April 2014. Liver metastases entirely surrounded by normal liver parenchyma were classified as hematogenous lesions. Results: The mean age at the moment of primary cytoreduction was 58 years. Two of the seven patients were submitted to neo-adjuvant chemotherapy. The main histopathological types were serous (5 cases), endometrial (1 case) and other subtypes (1 case). In six cases an R0 resection was performed. Minor hepatectomies (involving less than 2 liver segments) were performed in five cases, major hepatectomy (resection of more than 2 liver segments) was performed in one case while in another cases radiofrequncy ablation was performed. Postoperative morbidity was 14% (1/7 cases) while postoperative mortality was 0. Long term outcomes revealed a 12 months median overall survival for cases with hematogenous liver metastases. Although patients submitted to liver resection for peritoneal seeding reported a better outcome (with a reported median survival of 108 months), this fact did not reach statistical significance. Conclusions: Hepatic resection for parenchimatous ovarian cancer liver metastases can be safely introduced as part of cytoreductive surgery and may improve survival.