Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases

Abstract

Surgery for liver metastases arising from gastric adenocarcinoma is reasonable if complete resection seems feasible after careful preoperative staging, even if complete resection is not actually achieved. Hepatic resection should be considered as an option for gastric cancer patients with hepatic metastases.

Surgical resection of hepatic metastasis from gastric cancer: a review and new recommendation in the Japanese gastric cancer treatment guidelines

“…About 20 % of these patients underwent hepatectomy for cure. In contrast, 1,013 of 10,259 patients (9.9 %) diagnosed as gastric cancer in the Yonsei University Health System, Korea, had synchronous or metachronous liver metastases [9]. Of these, 58 had metastases confined to the liver and 41 (only 4 % of all patients with liver metastases) underwent surgery with curative intent, which denotes management of both the primary tumor and the liver.…”

“…Sixty-eight articles were identified, of which the following were excluded: 15 articles that included either other types of distant metastases or hepatic metastasis from other cancer types with no independent outcome data for gastric cancer metastases, 15 articles with emphasis on treatment modalities other than hepatectomy, 6 articles with fewer than 15 cases, 5 articles on prediction and diagnosis of hepatic metastasis, 4 review articles, 3 articles on irrelevant subjects, and 1 article describing only hepatic metastasis from pT1 stage cancer. Three articles analyzed patients from the same institution, and the most recent report by Takemura et al [6] was selected and added to a total of 17 articles to be analyzed in the current review [2,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Most of the papers were retrospective singleinstitution analyses of consecutive patients who underwent hepatectomy during a given period, with two exceptions in which patients were recruited from multiple institutions [5,7].…”

“…Wang et al [8] analyzed only patients with synchronous liver metastases, but all other papers discussed both synchronous and metachronous metastases. Two papers analyzed all patients with hepatic metastasis who underwent gastrectomy, regardless of whether the patients underwent hepatectomy [9,10]. Data of the patients who went on to receive hepatectomy could be retrieved from these reports for subsequent analyses.…”

Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302)

“…By contrast, colorectal liver metastases are widely considered as targets of surgery with an intent to cure because they often present as liver-only diseases, and R0 resection showed favorable survival in a recent clinical study [8]. Recently, the Guidelines Committee of the Japan Gastric Cancer Association reconsidered the treatment of potentially resectable M1 disease [9], on the basis of a report that showed favorable results in resectable liver metastases [10][11][12][13][14][15][16][17][18][19][20]. Therefore, the importance of liver resection for liver metastasis must be thoroughly analyzed.…”

Survival benefit of gastrectomy ± metastasectomy in patients with metastatic gastric cancer receiving chemotherapy

“…GC mortality has remained high due to the frequent initial presentation with distant metastasis. Although surgery is mandatory for the cure of locoregional GC, the role of surgery for metastatic gastric cancer (MGC) is controversial [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. For patients with MGC, palliative chemotherapy and best supportive care are considered the only standard treatment to achieve extension of survival and palliation of symptoms [19].…”