Clinical benefit of surgical management for gastric cancer with synchronous liver metastasis

Hepatogastroenterology. 2014 Jul-Aug;61(133):1439-45.

Abstract

Background/aims: The aim of this study was to evaluate the benefit of resection for liver metastasis from gastric cancer.

Methodology: Consecutive 74 patients of gastric cancer who undergone the gastrectomy for primary gastric cancer and simultaneous hepatic resection for synchronous liver metastasis were enrolled. The clinicopathological factors were retrospectively compared to the prognosis.

Results: The median survival time and 5-year overall survival rate in 53 patients who accomplished microscopically negative margin resection was 27.4 months and 18.6%, respectively. In the multivariate survival analysis, the number of liver metastasis was identified as an independent prognostic factor (HR;2.232, 95%CI;1.036-4.808, p=0.04). When the patients undergone curative resection were subdivided into solitary and multiple liver metastasis, the median survival time and 5-year overall survival rate in a subgroup with solitary liver metastasis was 24.2 months and 27.2%, which was superior to the corresponding values of 12.6 months and 5.5% in another group with multiple liver metastasis (p=0.02).

Conclusions: The resection for liver metastasis might offer a chance for long-term survival in a carefully selected group of patients. The number of liver metastasis was a reliable criterion to discriminate the subgroup of patients who are most likely to benefit from hepatic resection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gastrectomy*
  • Hepatectomy* / adverse effects
  • Hepatectomy* / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Male
  • Metastasectomy / adverse effects
  • Metastasectomy / methods*
  • Metastasectomy / mortality
  • Middle Aged
  • Multivariate Analysis
  • Patient Selection
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery*
  • Time Factors
  • Treatment Outcome