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SF012/#265  Non-anatomical liver resection in a case of solitary liver metastasis
  1. Shalini Rajaram1,
  2. Ayush Heda1,
  3. Nirjhar Raj2,
  4. Neeraj Yadav2,
  5. Lakhwinder Singh1,
  6. Nilotpal Chowdhury3,
  7. Dipendra Sharma4 and
  8. Samikshya Thapa3
  1. 1AIl India Institute of Medical Sciences, Rishikesh, Gynecologic Oncology (Obstetrics and Gynecology), Rishikesh, India
  2. 2AIl India Institute of Medical Sciences, Rishikesh, Surgical Gastroenterology, Rishikesh, India
  3. 3AllMS Rishikesh, Pathology, Rishikesh, India
  4. 4AIl India Institute of Medical Sciences, Rishikesh, Dept of Obstetrics and Gynecology), Rishikesh, India


Introduction Ovarian cancer is diagnosed at an advanced stage (FIGO stage IIIC-IV) in approximately 60–80% of cases and aggressive, complex surgical procedures are often needed to achieve an optimal cytoreduction. Liver metastasis is one of the most common organs for metastasis portending a poor prognosis. We present a surgical video of non-anatomical liver resection (wedge resection) for oligometastatic disease in a case of high-grade serous carcinoma ovary during interval cytoreductive surgery.

Description 34-year P2L2A2 with high-grade serous carcinoma right ovary post right salpingo-oophorectomy with persistent solitary liver metastasis after 4 cycles of neoadjuvant chemotherapy for liver resection is presented. Intra-operatively, peritoneal washings, total abdominal hysterectomy, left salpingo-oophorectomy, retroperitoneal lymph node sampling, supracolic omentectomy and excision of 2×2 cm peritoneal deposit adjacent to segment VI of liver was done. Intra-operative USG was used to localize the intraparenchymal lesion in segment IV/V of liver which measured 2.5×2 cm. Non-anatomical liver resection was done with adequate resection margins after ligation of distal middle hepatic vein. Post-operative course was uneventful and final histopathology reported the lesion and peritoneal deposit to be positive for metastatic carcinoma.

Conclusion/Implications Non-anatomical liver resection should become part of cytoreductive surgery, especially in surgically approachable oligometastatic disease. Feasibility of liver resection has recently been reported in a systematic review. However further studies are needed to address the prognostic impact of liver resections.

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