Surgical Treatment of Liver Metastases from Gastric Cancer

Daniel Vasilev Kostov, Georgi Leonidov Kobakov, Daniel Veselov Yankov

Clinic of Surgery, Specialized Hospital for Oncologic Diseases of Varna, Varna, Bulgaria.
Department of Surgery, Naval Hospital of Varna, Varna, Bulgaria.

DOI: 10.4236/ss.2013.49077                

Abstract

Background: Hepatectomy for gastric metastases remains controversial. We aimed at assessing the surgical results, clinicopathological features of gastric cancer liver metastases (GCLM) and prognostic factors. Methods: The outcome of 28 consecutive patients with synchronous (n = 24) or metachronous (n = 4) GCLM was retrospectively analyzed. Curatively, initial hepatectomies such as segmentectomy and hemihepatectomy or non-anatomical limited liver resection less extensive than segmentectomy followed complete primary gastric cancer (GC) resections. Results: Median survival time was 16 months (range, 5 - 66 months). The actuarial overall 12-, 36-, and 60-month survival rates after hepatectomy were 67.8% (n = 19), 39.2% (n = 11), and 28.5% (n = 8), respectively. In multivariate analysis, absent GC serosal invasion-hazard ratio (HR) 1; 95% confidence interval (CI) 1.2 - 9.9; P = 0.020; solitary LM-HR 1; 95% CI 1.6 - 16.0; P = 0.005, and curative liver resection with negative resection margin (R0)-HR 1, 95% CI 2.2 - 18.0; P = 0.001 were independent prognostic factors. Conclusions: Surgery of GCLM is a good indication in well-selected patients with an absent serosal invasion of primary tumour, single GCLM and attainment of R0 liver resection. For most GCLM patients, however, there are no other therapeutic modalities. Thus systemic chemotherapy remains the best hope for a longer patient’s survival and an improved individual quality of life.

Keywords

Gastric Cancer; Liver Metastases; Hepatectomy; Survival; Prognostic Factors; Univariate Analysis; Multivariate Analysis

Conflicts of Interest

The authors declare no conflicts of interest.

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