Hepatic Resection for Metastatic Tumors From Gastric Cancer

Abstract

Solitary and metachronous metastases from gastric cancer should be treated by a surgical approach and confer a better prognosis. A new prognostic factor, the presence of a pseudocapsule, may be helpful in defining indications for postoperative adjuvant treatment.

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

“…The 5-year survival reported from each series ranged from 0 % to 37 % and exceeded 30 % in five series [6,10,12,15,16]. Median survival time ranged from 9 to 38.8 months.…”

“…It may be of note that they currently consider surgery when the number of metastatic nodules was diagnosed as three or fewer, using state-ofthe-art imaging tools. As for other prognostic factors, some have found metachronous hepatic metastases to be a sign of favorable prognosis [11,12,20] whereas others consider this as irrelevant. In addition, status of the primary tumor such as serosal invasion, lymphatic invasion, and clinical stage were listed as relevant prognostic factors.…”

“…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].…”

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.…”

Surgical treatment of recurrent gastric cancer

“…However, the stage of disease at the time of the initial surgery infl uences peritoneal and hematogenous recurrence [5,11]. The most common hematogenous recurrences occur in the liver, and their surgical treatment is not widely accepted, but studies about the treatment of liver metastases from gastric cancer have reported improved survival in such surgically treated patients [11][12][13][14][15][16]. Another type of peritoneal recurrence, Krukenberg tumor (ovarian metastasis), has a low incidence rate, ranging from 0.7% to 6.7%.…”