Strategies for treating liver metastasis from gastric cancer

Kakeji, Yoshihiro; Morita, Masaru; Maehara, Yoshihiko

doi:10.1007/s00595-009-4152-0

Cited by 48 publications

(38 citation statements)

References 71 publications

(83 reference statements)

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“…For group 1 patients, the prognosis of gastric cancer with concomitant liver metastasis is poor with a 5-year survival of \10 % [27,28]. Despite curative hepatectomy, recurrence was previously reported in 62 % of patients, with most cases developing intrahepatic recurrence [29], suggesting the presence of occult intrahepatic metastases even at the time of hepatectomy.…”

Section: Discussionmentioning

confidence: 98%

Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study

et al. 2016

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Background Conversion therapy is an option for unresectable metastatic gastric cancer when distant metastases are controlled by chemotherapy; however, the feasibility and efficacy remain unclear. This study aimed to assess the feasibility and efficacy of conversion therapy in patients with initially unresectable gastric cancer treated with docetaxel, cisplatin, and S-1 (DCS) chemotherapy by evaluating clinical outcomes.Methods One hundred unresectable metastatic gastric cancer patients, enrolled in three DCS chemotherapy clinical trials, were retrospectively evaluated. The patients received oral S-1 (40 mg/m 2 b.i.d.) on days 1-14 and intravenous cisplatin (60 mg/m 2 ) and docetaxel (50-60 mg/m 2 ) on day 8 every 3 weeks. Conversion therapy was defined when the patients could undergo R0 resection post-DCS chemotherapy and were able to tolerate curative surgery. Results Conversion therapy was achieved in 33/100 patients, with no perioperative mortality. Twenty-eight of the 33 patients (84.8 %) achieved R0 resection, and 78.8 % were defined as histological chemotherapeutic responders. The median overall survival (OS) of patients who underwent conversion therapy was 47.8 months (95 % CI 28.0-88.5 months). Patients who underwent R0 resection had significantly longer OS than those who underwent R1 and R2 resections (P = 0.0002). Of the patients with primarily unresectable metastases, 10 % lived [5 years. Among patients who underwent conversion therapy, multivariate analysis showed that the pathological response was a significant independent predictor for OS. Conclusions DCS safely induced a high conversion rate, with very high R0 and pathological response rates, and was associated with a good prognosis; these findings warrant further prospective investigations.

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Section: Discussionmentioning

confidence: 98%

Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study

et al. 2016

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“…For patients with liver metastasis from gastric cancer, palliative treatment is regarded the standard of care, since their disease is incurable and their life expectancy is dreadfully short. To improve survival, various liver-directed treatment strategies for liver metastasis from gastric cancer, in combination with systemic chemotherapy, have been applied, such as surgical resection, radiofrequency ablation (RFA), and hepatic artery infusion chemotherapy [7][8][9][10][11]. Meanwhile, for liver metastases from colorectal cancer and neuroendocrine tumors, surgical resection is the treatment of choice [12,13].…”

Section: And Woo Jin Hyungmentioning

confidence: 99%

Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation

et al. 2015

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Background Although various liver-directed treatment modalities, such as liver resection and radiofrequency ablation (RFA), have been applied to treat liver metastases from gastric cancer, optimal management of them remains controversial. In patients with liver metastasis from gastric cancer, we investigated the short-and long-term outcomes of liver resection and RFA and analyzed factors influencing survival. Methods A total of 98 gastric cancer patients with liver metastasis and no extrahepatic disease were treated by liver resection (n = 68) or RFA (n = 30). Short-and long-term outcomes were evaluated retrospectively for each of the liver-directed treatments. Results Severe complication rates did not differ between liver resection (18 %) and RFA (10 %) (p = 0.333). Only one treatment-related mortality occurred in the liver resection group. No statistically significant difference in survival was noted between the treatment groups. Median overall survival after liver resection was 24 months, with 3-year overall and progression-free survival rates of 40.6 % and 30.4 %, respectively. Median overall survival after RFA was 23 months, with 3-year overall and progression-free survival rates of 43.0 % and 37.4 %, respectively. Only the size of the metastases was shown to be an independent prognostic factor for gastric cancer patients with liver metastasis. Conclusions In select patients with liver metastasis from gastric cancer, liver resection and RFA showed satisfactory and comparable short-and long-term results. Thus, systemic chemotherapy may not be the only therapeutic option for patients with liver metastasis, and possible liver-directed treatment options for such patients should be considered on an individual basis.

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“…Newer cytotoxic agents, such as S-1, irinotecan, and taxanes, have been linked to promising outcomes in patients with metastases. In the future, adjuvant chemotherapy or molecular targeted therapy may provide significant benefits to patients (Kakeji et al, 2010). In this report, we describe a patient with GCLM whose metastases completely resolved after preoperative chemotherapy with a trastuzumab-containing regimen.…”

Section: Introductionmentioning

confidence: 96%

Preoperative chemotherapy with a trastuzumab-containing regimen for a patient with gastric cancer and hepatic metastases

Li¹,

Shan²,

Zhang³

et al. 2014

Genet. Mol. Res.

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ABSTRACT. Gastric cancer is the fourth most common cancer worldwide and the leading cause of tumor-related death in China. Gastric cancer is a heterogeneous disease and therefore requires different treatments based on the subtype. We describe a patient who had gastric cancer with liver metastases. Biopsy and tumor analysis using the HercepTest revealed a human epidermal growth factor receptor 2 (HER2)-positive adenocarcinoma as confirmed by fluorescence in situ hybridization. The patient was treated with a regimen of trastuzumab, oxaliplatin, and S-1 (six cycles). When positron emission tomography findings suggested that the metastases had resolved, the patient underwent surgery. Histopathologically, no cancer cells were observed in the resected hepatic tissue. The patient underwent tumor resection surgery, during which the tumor and gastric lymph nodes with lesions were removed. The patient has remained disease-free for 3 months. Therefore, trastuzumab may be an effective agent in the chemotherapeutic treatment of liver metastases

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Strategies for treating liver metastasis from gastric cancer

Cited by 48 publications

References 71 publications

Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study

Conversion therapy for inoperable advanced gastric cancer patients by docetaxel, cisplatin, and S-1 (DCS) chemotherapy: a multi-institutional retrospective study

Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation

Preoperative chemotherapy with a trastuzumab-containing regimen for a patient with gastric cancer and hepatic metastases

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