Abstract
Gastric cancer with liver metastasis is defined as advanced gastric cancer and remains one of the deadliest diseases with poor prognosis. Approximately 4–14% of patients with gastric cancers presented with liver metastases at the initial diagnosis. Owing to its incurability, first-line treatment for gastric cancer with liver metastases is systematic chemotherapy, whereas surgery is usually performed to alleviate severe gastrointestinal symptoms. However, continuously emerging retrospective studies confirmed the role of surgery in gastric cancer with liver metastases and showed significantly improved survival rate in patients assigned to a group of surgery with or without chemotherapy. Therefore, more and more convincing data that resulted from prospective randomized clinical trials is in need to clarify the surgery strategies in patients with gastric cancer with liver metastasis.
Highlights
Gastric cancer (GC), as the third most frequent cause of cancer-related death for human cancers in the world, continues to carry a noticeably higher fatality-to-case ratio, accounting for exceeding 782,000 confirmed cases died in 2018 worldwide [1]
Gastric cancer with liver metastases (GCLM) is generally classified into two types: one is synchronous metastases, which defined as metastases occurring before or during surgery or within 6 months after gastrectomy, and the other is metachronous metastases, which defined as metastases identified at least 6 months after gastrectomy [5]
Increasing systemic and aggressive oncological behaviors were shown in GCLM [18], compared with colorectal cancer liver metastases; gastrectomy was reserved for the palliation of severe gastrointestinal symptoms such as refractory hemorrhage and obstruction in patients with GCLM based on National Comprehensive Cancer Network (NCCN) [8]
Summary
Gastric cancer with liver metastasis is defined as advanced gastric cancer and remains one of the deadliest diseases with poor prognosis. 4–14% of patients with gastric cancers presented with liver metastases at the initial diagnosis. First-line treatment for gastric cancer with liver metastases is systematic chemotherapy, whereas surgery is usually performed to alleviate severe gastrointestinal symptoms. Continuously emerging retrospective studies confirmed the role of surgery in gastric cancer with liver metastases and showed significantly improved survival rate in patients assigned to a group of surgery with or without chemotherapy. More and more convincing data that resulted from prospective randomized clinical trials is in need to clarify the surgery strategies in patients with gastric cancer with liver metastasis
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