Surgery for Liver Metastases From Gastric Cancer

Martella, Luca; Bertozzi, Serena; Londero, Ambrogio P.; Steffan, Agostino; Paoli, Paolo De; Bertola, G.

doi:10.1097/md.0000000000001113

Cited by 27 publications

(24 citation statements)

References 57 publications

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“…Thus far, many investigators have agreed that age, histological type, N-stage and radiation status were independent prognostic factors [16, 17, 18, 19, 20, 21]. In our study, using a multivariate analysis, we arrived at the same conclusions and found that surgery was an additional independent prognostic factor.…”

Section: Discussionsupporting

confidence: 81%

“…Although systemic chemotherapy is the standard treatment strategy, the MST of these patients is only approximately 12 months, and long-term survival beyond 5 years is rare [14, 15]. Recently, it was reported that in selected cases, especially in patients with gastric cancer with liver metastases, aggressive surgical treatment may lead to unexpected results [16, 17, 18, 19, 20]. In a review based on 19 studies, Kerkar et al reported that the 5-year survival rate of gastric cancer patients with liver metastases who underwent liver resection was 26.5% (range: 0-60%) [16].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Kodera et al analysed 17 studies that involved patients with gastric cancer with liver metastases and showed that the MST ranged from 9.0 to 38.8 months among patients who underwent surgical resection [17]. Recently, two meta-analyses also verified that hepatectomy might be associated with the significant improvement in overall survival [18, 19]. In an analysis of 39 studies that involved patients with gastric cancer with liver metastases who underwent hepatectomy, Markar et al found that the median 1-year, 3-year, and 5-year survival rates were 68%, 31%, and 27%, respectively [18].…”

Section: Discussionmentioning

confidence: 99%

“…In an analysis of 39 studies that involved patients with gastric cancer with liver metastases who underwent hepatectomy, Markar et al found that the median 1-year, 3-year, and 5-year survival rates were 68%, 31%, and 27%, respectively [18]. In another meta-analysis of 11 observational studies, Martella et al reported a significantly higher survival rate in the patients who underwent the most aggressive surgery for liver metastases (HR = 0.54, 95% CI 0.46-0.95) compared with patients who underwent palliative treatment only [19]. Studies of gastric cancer patients with distant metastases other than those to the liver who underwent curative surgery are scarce.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of surgery for gastric cancer with distant metastases: a retrospective study from the SEER database

et al. 2016

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BackgroundThe role of surgical therapy in gastric cancer patients with distant metastases remains controversial. This retrospective analysis was performed to identify whether gastric cancer patients with distant metastases might benefit from surgery.Patients and methodsA total of 5185 patients from the SEER database who were initially diagnosed with histologically confirmed gastric cancer with distant metastases from 2004 to 2009 were included. Patients were divided into the following three groups: patients who underwent resection of both the primary tumor and distant metastatic tumors (‘PMTR’ group), patients who only underwent resection of the primary tumor (‘PTR’ group) and patients who did not undergo any surgery (‘No surgery’ group). We employed the Kaplan-Meier analysis, the log-rank test and multivariate Cox proportional hazards regression models to estimate the survival time of the different groups.ResultsA total of 5185 patients had a median survival time (MST) of 9.0 months. The improvement in survival of the ‘PMTR’ and ‘PTR’ groups was significantly different compared with that of the ‘No surgery’ group (MST, 12.0 vs 12.0 vs 9.0 months, respectively, P<0.001; 1-year survival rate, 49.6% vs 49.1% vs 30.1%, respectively, P<0.001; 3-year survival rate, 12.5% vs 15.1% vs 5.8%, respectively, P<0.001), whereas no significant difference was found between the ‘PMTR’ group and ‘PTR’ group (P=0.642). Multivariate Cox proportional analysis showed that surgery was an independent prognostic factor (‘PMTR’, hazard ratio (HR) =0.648, 95% confidence interval (CI) 0.574-0.733, P<0.001; ‘PTR’, HR=0.631, 95% CI 0.583-0.684, P<0.001).ConclusionsThis retrospective analysis demonstrated that combined PTR and metastasectomy or PTR alone were independent prognostic factors for survival improvement in gastric cancer patients with distant metastases. Because no statistically significant difference in survival was observed between the ‘PMTR’ group and ‘PTR’ group, PTR, which is a more minor surgery, might be more appropriate than PMTR in clinical practice for gastric cancer patients with distant metastases.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of surgery for gastric cancer with distant metastases: a retrospective study from the SEER database

et al. 2016

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“…Finally, other publications [35,36] and results obtained by our clinic (although they concern a small group of patients, as in other single liver surgery centers) indicate that in some patients (single metachronous metastasis, no extrahepatic lesions, no peritoneal lesions, with subsequent chemotherapy) liver resection due to gastric cancer metastases offers a better chance of survival than just chemotherapy.…”

Section: Discussionsupporting

confidence: 58%

Metastases of gastric cancer into the liver – the authors’ own experience and literature review

Krawczyk¹,

Skalski²,

Grąt³

et al. 2019

Nowotwory. Journal of Oncology

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Introduction . Synchronous metastases of gastric cancer to the liver occur in 3-14% of patients with this cancer, and metachronous lesions in 37% of patients after radical gastrectomy. Liver resections due to metastases of gastric carcinomas represent only 5-9% of resections due to metastases other than colorectal cancer. Until recently, patients with gastric carcinoma metastases to the liver were classified in the IV stage of cancer and the therapy was limited to chemotherapy or palliative treatment only. Material and methods . The paper presents a current review of literature and the authors' own experience with liver resection due to gastric cancer metastases into this organ. During 34 months, 488 patients with liver metastases were treated in the Department of General, Transplant and Liver Surgery, of the Medical University of Warsaw, in whom 426 surgical procedures were performed (87.3%). The types of surgical procedures are as follows: minor liver resections in 204 patients (47.9%), hemihepatectomies in 102 patients (23.9%), thermoablations in 86 patients (20.2%) and laparotomies in 34 patients (8.0%). Among patients treated for liver metastases there were 4 patients with metastases from gastric cancer (0.8%), which constituted 1% of patients operated on, but 6.8% of patients with liver metastases from organs other than colorectal cancer. The postoperative course and direct results in all patients operated because of gastric cancer metastases into the liver were very good. Conclusions . In some patients (single metachronous metastasis, no extrahepatic lesions, no peritoneal lesions, with subsequent chemotherapy) liver resection due to metastases from gastric cancer provides a chance for a longer survival.

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