Background The necessity of surgical treatment of liver metastases of gastric cancer is still controversial. Patients and methods We conducted a multicenter retrospective cohort study of liver-limited metastasis of gastric cancer treated surgically between 2000 and 2010. In this study, 103 patients were registered, with nine patients excluded from the analysis as they did not meet the eligibility criteria.Results Of the 94 patients, 69 underwent surgical resection, 11 underwent surgical resection combined with radiofrequency ablation or microwave coagulation therapy for small or deep tumors, and 14 underwent radiofrequency ablation or microwave coagulation therapy only. Synchronous and metachronous metastases were found in 37 and 57 patients, respectively. The 3-and 5-year overall survival rates of all the patients were 51.4 and 42.3 %, respectively. The 3-and 5-year relapse-free survival rates were 29.2 and 27.7 %, respectively. No significant difference in prognosis was observed between the patients who underwent surgical resection and those who underwent ablation therapy. The patients with hepatic solitary lesions and low-grade lymph node metastases of primary gastric cancer had significantly better overall survival and relapsefree survival. Conclusions To our knowledge, this study is the largest series and first multicenter cohort study of liver-limited metastasis of gastric cancer. The study indicated that patients with a single liver metastasis with a grade lower than N2 lymph node metastasis of the primary lesion are the best candidates for liver resection.

This retrospective, multi-institutional analysis showed that, in patients who undergo curative hepatectomy for HCC, the preoperative CONUT score is predictive of worse OS and RFS, even after propensity score matching analysis.

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To study the causes of postoperative hepatic failure in cirrhotic patients undergoing resection for hepatocellular carcinoma, we evaluated data on 126 cirrhotic patients surgically treated from 1977 to 1987. The records of 102 patients with a good postoperative course (survival group) and 24 patients who developed hepatic failure and died (hepatic failure group) were reviewed. No difference in preoperative liver function was apparent between the 2 groups. Histologically, moderate to severe inflammatory activity in the liver was present in 20 (83%) of 24 patients in the hepatic failure group. Major hepatic resections (lobectomy and extended lobectomy) were more frequent in the hepatic failure group. Mean perioperative blood loss was 1,945 g and 4,322 g in the survival and hepatic failure groups, respectively, with a significant difference (p less than 0.01). Major postoperative complications occurred in 22 (22%) of 102 patients in the survival group and major complications followed by hepatic failure occurred in 21 (88%) of 24 patients in the hepatic failure group, with a significant difference (p less than 0.001). In light of these data, we propose that: (a) histological examination should be done before the resection, (b) perioperative blood loss should be less than 2,000 g, and (c) intensive care is needed postoperatively to prevent complications which might lead to hepatic failure.

Specific gene-expression signatures in noncancerous liver tissue may help to accurately predict the risk for developing HCC.