Elsevier

Surgery

Volume 133, Issue 5, May 2003, Pages 507-511
Surgery

Original Communications
Surgical resection of liver metastases of gastric cancer: An analysis of a 17-year experience with 22 patients*,**

https://doi.org/10.1067/msy.2003.147Get rights and content

Abstract

Background. The justification for surgical resection of liver metastases from gastric cancer remains controversial. Methods. Twenty-two patients who underwent 26 hepatectomies for liver metastases of gastric cancer between 1985 and 2001 were analyzed. Fifteen clinicopathologic factors were evaluated with univariate and multivariate analyses for survival after hepatic resection. Results. The overall 1-year, 3-year, and 5-year survival rates after hepatectomy for gastric metastases were 73%, 38%, and 38%, respectively. Five patients survived for more than 3 years without recurrence, 3 of whom had synchronous metastases resected at the time of gastrectomy. The best results after surgical resection for liver metastases of gastric cancer were obtained with solitary metastases less than 5 cm in size. The number of liver metastases (solitary or multiple) was the only significant prognostic factor according to both univariate and multivariate analyses. Conclusion. Surgical resection for liver metastases of gastric cancer may be beneficial for patients with a solitary metastasis, whether it is synchronous or metachronous. (Surgery 2003;133:507-11.)

Section snippets

Methods

Between 1985 and 2001, 4730 patients underwent gastrectomy for gastric adenocarcinoma at the Department of Surgery, Cancer Institute Hospital. Of these 4730 patients, 106 patients (2%) had synchronous liver metastases, and 122 patients (3%) had metachronous liver metastases develop after resection of the primary gastric cancer. Synchronous liver metastases were found with routine abdominal computed tomography before gastrectomy. Twenty-two patients (13 male and 9 females; median age, 63 years;

Results

Surgical procedures for the primary gastric cancer consisted of 12 partial gastrectomies and 10 total gastrectomies. Twelve synchronous and 10 metachronous liver metastases were identified; 1 of the patients with a synchronous liver metastasis underwent a staged hepatectomy 2 months after a gastrectomy for primary cancer. The number of metastases at the time of the first hepatectomy was 1 in 16 patients, 2 in 2 patients, 3 in 2 patients, 5 in 1 patient, and 7 in 1 patient. The maximum size of

Discussion

We found 5% of the 4730 patients who underwent gastrectomy for gastric cancer at our institution between 1985 and 2001 developed liver metastases develop synchronously or metachronously, but only 10% of them underwent hepatic resection. This small population of patients is discussed in this study. The number of liver metastases was a significant prognostic factor for survival after hepatectomy in patients with metastasis of primary gastric cancer according to a univariate and a multivariate

References (19)

There are more references available in the full text version of this article.

Cited by (171)

View all citing articles on Scopus
*

Reprint requests: Junji Yamamoto, MD, Department of Surgery, Cancer Institute Hospital, 1-37-1 Kami-Ikebukuro, Toshima-ku, Tokyo 170-8455, Japan.

**

0039-6060/2003/$30.00 + 0

View full text