Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience

Abstract

Background and objectives: Gastric cancer (GC) is often diagnosed in the metastatic stage. Palliative systemic therapy is still considered the gold standard, even for patients with resectable oligometastatic disease. The aim of the current study is to assess the potential benefit of up-front gastric and liver resection in patients with synchronous resectable liver-only metastases from GC (LMGC) in a Western population. Materials and Methods: All patients with GC and synchronous LMGC who underwent gastric resection with or without simultaneous resection of LMs between January 1997 and December 2016 were selected from the institutional records. Those with T4b primary tumors or with unresectable or more than three LMs were excluded from the analysis. All patients who underwent emergency surgery for hemorrhagic shock or gastric perforation were also excluded. Results: Out of 28 patients fulfilling the inclusion criteria, 16 underwent simultaneous gastric and liver resection (SR group), while 12 underwent palliative gastric resection (GR group). The median overall survival (OS) of the entire cohort was of 18.81 months, with 1-, 3- and 5-year OS rates of 71.4%, 17.9% and 14.3%, respectively. The 1-, 3- and 5-year OS rates in SR group (75%, 31.3% and 25%, respectively) were significantly higher than those achieved in GR group (66.7%, 0% and 0%, respectively; p = 0.004). Multivariate analysis of the entire cohort revealed that the only independent prognostic factor associated with better OS was liver resection (HR = 3.954, 95% CI: 1.542–10.139; p = 0.004). Conclusions: In a Western cohort, simultaneous resection of GC and LMGC significantly improved OS compared to patients who underwent palliative gastric resection.

Simultaneous Resection for Colorectal and Liver Metastases, new equipment and personalized medicine

“…In group B were hepatectomy is performed the rearrangement of the patient's position takes less time. We use the Pringle maneuver to control liver inflow [16][17][18][19][20][21]. Although, sometimes lower volume may is observed which causes circulatory disorders in organs, and therefore performing the Pringle should be used only when necessary.…”

Development and Validation of a Cancer-Specific Early Death Prediction Model for Patients with Gastric Cancer with Liver Metastasis: Based on Machine Learning

“…Patients with GCLM generally experience unfavorable outcomes, often encounter early death, and encounter signi cant controversy regarding comprehensive treatment approaches. (11,12,13,14) In recent years, the early mortality of GCLM patients has attracted widespread attention among medical researchers. However, reports on cancer-speci c early mortality and associated factors in GCLM patients are scarce.…”

Management of Oligometastatic Disease in Esophagogastric Cancer: What Is the Evidence?

“…Minciuna et al [22] reported on retrospective study to assess the potential benefit of up-front liver and/or primary gastrectomy in patients with potentially resectable gastric cancer (GC) and synchronous OMD (less than 3 metastases) limited to the liver. Out of 28 patients fulfilling the inclusion criteria, 16 underwent simultaneous gastric and liver resection (simultaneous resection, while 12 underwent palliative gastric resection alone.…”