Outcome of Hepatic Resection for Metastatic Gastric Cancer

Abstract

The role of hepatic resection for metastatic gastric cancer is less well defined due to the tendency of gastric cancer to widely metastasize. The purpose of this study is to examine the beneficial effect of hepatic resection in patients with metastatic gastric cancer. The clinicopathologic features and long-term results of 11 patients who underwent hepatic resection for metastatic gastric cancer from January 1988 to December 1996 at Seoul National University Hospital were analyzed retrospectively. All resected hepatic metastases were solitary lesions. Among eight patients with synchronous hepatic metastases, one patient with early gastric cancer and lymph node metastases (T1N2M1) remained alive for 8 years 6 months after hepatic resection without recurrence. Among three patients with metachronous hepatic metastases, two patients with advanced gastric cancer and lymph node metastases (T3N2M0, T2N1M0 at the initial operation, respectively) survived 8 years 6 months and 3 years after hepatic resection, respectively. Median survival times of synchronous and metachronous hepatic metastases were 13.0 and 74.3 months, respectively. In solitary hepatic metastatic lesions from gastric cancer, surgical resection should be considered as one of the treatment options.

Hepatic resection for the treatment of liver metastases in gastric carcinoma: review of the literature

“…Zacherl et al 9 suggested that the in‐hospital mortality rate might be higher in patients who underwent synchronous hepatic resection than in those who underwent metachronous hepatic resection. In 12 reports 3–14 , three of four hepatic resection patients who died in hospital and had detailed documentation, underwent synchronous hepatic resection. Careful patient selection may be necessary, especially in the patients with synchronous hepatic metastases from gastric cancer.…”

“…The incidence of intrahepatic recurrence ranged from 47% to 73%. Although no papers in this series 3–14 have proven the efficacy of adjuvant chemotherapy, aggressive hepatic artery infusion chemotherapy might improve survival after hepatic resection 15–17 . Further investigation is necessary.…”

“…complete resection of hepatic metastases with acceptable postoperative hepatic function. In a recent report by Roh et al 14 , hepatic resection is said to be indicated only in patients with hepatic metastases in one lobe of the liver without peritoneal dissemination, hilar node metastases or distant metastases. Below, we examine prognostic factors and discuss the significance of these criteria.…”

“…In contrast, reports of hepatic resection for liver metastases from gastric cancer are rare, and the indications for hepatic resection of metastases from gastric cancer have not been established. Several authors have reported on hepatectomy of liver metastases from gastric cancer in a small number of the patients 3–14 . The long‐term results after hepatic resection are disappointing, although long‐term survivors after hepatectomy do exist.…”

“…Therefore, the determination of selection criteria for hepatic resection and conditions for long‐term survival after hepatectomy for metastases from gastric cancer is crucial. To our knowledge, 12 studies of hepatic resection for metastatic gastric carcinoma have been published 3–14 . The number of patients in these 12 reports varied from 11 to 40, and the total number of patients was 229.…”