title: Aggressive surgery for liver metastases from gastrointestinal stromal tumors.
abstract: OBJECTIVE
  The utility of hepatectomy for patients with metastatic liver tumors from gastrointestinal stromal tumors (GISTs) was evaluated in the present study.
  
  
  METHODS
  Between 1989 and 2001, ten patients with liver metastases from GIST (four men and six women; age, 34-77 years) underwent hepatectomy at our hospital. All patients underwent complete resection of the primary tumor and hepatectomy with or without microwave coagulation therapy (MCT) for all detectable hepatic tumors.
  
  
  RESULTS
  The median survival time after hepatectomy was 39 months (range, 1 to 96 months). There was one postoperative death. One patient is still alive with relapse of hepatic tumors, and the remaining eight patients died of disease (liver in six, peritoneum in one, and bone in one). Relapse of hepatic tumors occurred in seven patients. The disease-free rate after hepatectomy was 22% at 2 years and 11% at 5 years. The survival times of the four patients who received hepatic arterial chemoembolization for recurrent hepatic metastases were 7 months (still alive), 17, 23, and 28 months (average, 19 months).
  
  
  CONCLUSIONS
  Our data suggest that aggressive surgery (hepatectomy and MCT) for all detectable hepatic tumors and hepatic arterial chemoembolization for recurrent hepatic metastases improve survival.
authors.affiliation: Department of Surgery, Kochi Municipal Central Hospital, 2-7-33 Sakurai, Kochi 780-0821, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Shima
authors.forename: Tadashi
authors.initials: T
authors.lastname: Horimi
authors.forename: Tadanori
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Ichikawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Okabayashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nishioka
authors.forename: Madoka
authors.initials: M
authors.lastname: Hamada
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shibuya
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Ishii
authors.forename: Mitsuya
authors.initials: M
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000378:metabolism / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000556:secondary*