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2006 Abstracts: The role of hepatectomy for the patients with liver metastases of gastric cancer
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The role of hepatectomy for the patients with liver metastases of gastric cancer
Zenichi Morise, Atsushi Sugioka, Sojun Hoshimoto, Takazumi Kato, Akihiko Horiguchi, Shuichi Miyakawa; Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan

BACKGROUNDS and AIM: Although hepatic resection for colorectal liver metastases had become a gold standard of the therapy, the role of hepatic resection for those from gastric cancer has yet to been well defined. There are only a few reported series (10-30 patients, each) of hepatic resection for metastatic gastric cancer. We reviewed our cases of hepatic resection for metastatic gastric cancer and compared them to the cases of colorectal liver metastases. PATIENTS: Between 1989 and 2004, 18 patients underwent hepatic resection for liver metastases from gastric cancer in our department. They were 16 men and 2 women and their ages were in the range of 51-76 (mean 64.1) years old. Hepatic resection was indicated for patients with synchronous metastases who did not have peritoneal dissemination or any other distant metastases (11 patients), and patients with metachronous metastases who did not have any other recurrent lesions (7 patients). 14 patients had solitary and 4 had multiple liver metastases. Median follow up period was 64 (mean 91.6) months. RESULTS: Overall survival rate for 1,2,3, and 5 years are 56.3, 36.5, 27.3, and 27.3 %, respectively. Although the 5-year survival rate was considerable, they had early and rapid decrease of survival rate in the first 1-2 years (compared with the patients of colorectal liver metastases (153 cases between 1989 and 2004) who had 88.3, 66.9, 54.9, and 42.2 % of survival rate for 1, 2, 3, and 5 years, respectively). All patients with multiple metastases died within 1 year, and the survival rates of the patients with solitary and multiple metastases were significantly different (p<0.05). There was no significant difference observed between the outcomes of the patients with synchronous and metachronous metastases. CONCLUSION: Surgical resection for liver metastases of gastric cancer is thought to be beneficial for part of the patients (around 30%) with solitary metastasis. However, for the other patients, the survival curve after the resection dropped rapidly during the first 1-2 years. The procedure may provide only limited beneficial effects on the survivals of those patients. Further investigations for the favorable prognostic factors to select the patients and adjuvant therapy for those patients with poor prognosis should be needed.


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