title: Hepatic arterial infusion chemotherapy in gastric cancer: a report of four cases and analysis of the literature.
abstract: OBJECTIVE
  Gastric cancer is associated with high mortality. Although the liver is a common site of metastases in this tumor, the experience with liver-directed therapies is limited.
  
  
  METHODS
  We report a single-center experience involving four patients with liver metastases from gastric cancer treated by hepatic arterial infusion (HAI). In addition, we performed a search for reports on HAI in gastric cancer metastatic to the liver and used the studies with data on survival of individual patients for a pooled analysis.
  
  
  RESULTS
  Among three valuable patients, one had a complete response, one had stable disease and one had progressive disease. The patient with complete response is still alive 41 months after the diagnosis of liver metastases, while the other patients died 6, 22 and 31 months after the diagnosis. Objective responses were observed in 48% of the 25 patients in the pooled analysis. Objective response and limited hepatic involvement were independent predictors of survival in these patients.
  
  
  CONCLUSIONS
  Although isolated liver involvement in metastatic gastric cancer is rare, HAI seems to be similarly effective in these patients as in patients with liver metastases from colorectal cancer. The prognosis is significantly better in gastric cancer patients who have limited hepatic involvement and attain an objective response after HAI.
authors.affiliation: Department of Oncology & Radiotherapy, Charles University Medical School Teaching Hospital, Hradec Králové, Czech Republic. melichar@fnhk.cz
authors.forename: Bohuslav
authors.initials: B
authors.lastname: Melichar
authors.forename: Zbynĕk
authors.initials: Z
authors.lastname: Voboril
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Cerman
authors.forename: Karolina
authors.initials: K
authors.lastname: Melicharová
authors.forename: Jan
authors.initials: J
authors.lastname: Nozicka
authors.forename: Jindriska
authors.initials: J
authors.lastname: Mergancová
authors.forename: René
authors.initials: R
authors.lastname: Voboril
authors.forename: Pavel
authors.initials: P
authors.lastname: Jandík
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016461:Chemoembolization, Therapeutic; D005743:Gastrectomy / Q000379:methods; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome