Abstract
BackgroundThe prognosis of patients with liver metastases from gastric cancer (LMGC) is dismal, and little is known about prognostic factors in these patients; so justification for surgical resection is still controversial. Furthermore the results of chemotherapy for these patients are disappointing. The purpose of this study was to review recent outcomes of hepatectomy for LMGC and to determine the suitable candidates for surgery, assessing the surgical results and clinicopathologic features. Moreover we compare these results with those obtained with alternative treatments.
Highlights
Gastric cancer is the fourth most common cancer worldwide and account for 1.5% of all new diagnoses and 5.2% of all cancer deaths [1,2]
We reviewed the literature in which numerous factors were examined and their relationship to outcome assessed, in order to determine the benefits and the limits of hepatic resection for gastric metastases and to identify selection criteria for good outcome
Some hold the view that metastatic gastric cancer represent a systemic disease and the ‘tip of the iceberg’ of a diffuse cancer, and surgery has no role in its treatment, because the results of liver resection are still disappointing
Summary
Gastric cancer is the fourth most common cancer worldwide and account for 1.5% of all new diagnoses and 5.2% of all cancer deaths [1,2]. Shirabe et al [40] described the presence of three or more tumors as an independent poor prognostic factor according to both univariate and multivariate analysis; all four patients who survived beyond 5 years in their study had solitary tumors, and almost all patients described as long-term survivors (Table 1) had a solitary liver metastasis. Ueda [50] studied a cohort of 73 patients presenting synchronous metastases Their data show that factors influencing survival were the extent of hepatic involvement (H1-2 vs H3) and macroscopic peritoneal dissemination (P0 vs P1) detected at surgical exploration. The paper showed that 15 patients without extrahepatic disease treated by RFA ± chemotherapy displayed a median survival of 22 months, with 3- and 5- year survival rates of 50% and 40%, respectively, similar to those reported in surgical series (Table 2). Another paper of Kim et al [54] report worse survival results similar to those of classic systemic chemotherapy alone
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