PD-0017 - Effect on Survival of Surgery for Hepatic Metastases From Gastric Cancer

Abstract

Background: There is an intense debate about the indications for hepatic resection in patients with metastases from gastric cancer. The objective of the present study was to evaluate the effect on the postoperative survival rates of liver resection for gastric cancer liver metastases. Methods: Between 1992 and 2007, 769 GC patients were surgically treated. Of these, 89 patients (11.57%) presented with synchronous liver metastases and 53 (6.89%) developed metachronous LM after resection of the primary gastric cancer. Twenty-nine patients, 19 males and 10 females, at a mean age of 68 years with initial hepatectomy for synchronous (n = 25) or metachronous (n = 4) liver metastases from gastric cancer were covered by this study. Curative hepatectomies included segmentectomy, hemihepatectomy or non-anatomically limited liver resection less extensive than segmentectomy. Independent prognostic factors were identified by univariate and multivariate stepwise Cox regression analyses. Results: The actuarial overall one-, three-, and five-year survival rates after hepatic resection were 68.96 (n = 20), 41.13% (n = 12), and 27.58% (n = 8), respectively. Median survival time was 16 months (range 5-67 months). Rates of one-, three- and five-year disease-free survival were 55.17% (n = 16), 27.59% (n = 8), and 17.24% (n = 5), respectively. The independent prognostic factors revealed by multivariate analysis were the status of gastric cancer serosal invasion (p = 0.03), the number of liver metastases (p = 0.003), and the radicalism of liver resection (p = 0.001). Conclusion: It could be concluded that hepatectomy should be proposed to the patients with liver metastases from gastric cancer when the following requirements are met: 1) a good control of the primary tumour, 2) absent signs at preoperative diagnosis of disseminated diseases, 3) absence of serosal invasion of primary tumour, 4) a solitary liver metastasis, and 5) an attainment of curative liver resection (R0). A better survival of these patients could be achieved with their careful selection along with improved preoperative staging and timely multimodality treatment.