[Indication of hepatic resection for metastatic liver tumors from gastric cancer].
To clarify the benefit and indication of resection for metastatic liver tumors from gastric cancer, we reviewed the therapeutic outcomes at the Niigata University Medical Hospital and at a referred institution. From January 1982 to April 2004, thirty-nine patients with synchronous and 40 with metachronous liver metastases from gastric cancer had been treated. In synchronous cases, forty percent of the patients had many metastatic tumors in bilateral hepatic lobes and the majority of them had advanced gastric cancer with serosal invasion and widely spread of lymphatic metastases. On the other hand, over 70% of metachronous patients had unilobar or scattered bilobar metastases and only 20% of them accompanied other types of metastases. A survival analysis showed that the prognoses of patients undergoing hepatic resection were statistically better than other treatments in both synchronous and metachronous cases. And there was no evidence for the benefit of palliative gastrectomy. So we conclude that surgical treatment for hepatic metastases from gastric cancer is a beneficial option if all the lesions including the primary and lymphatic ones can be eradicated in limited candidates of synchronous cases and in more candidates of metachronous cases, especially unilobar and a few scattered bilobar metastases.
Ohashi
Manabu
M
Division of Digestive and General Surgery, Niigata Graduate School of Medical and Dental Sciences.
Kanda
Tatsuo
T
Muneoka
Katsuki
K
Ikeda
Yoshiyuki
Y
Yajima
Kazuhito
K
Tanabe
Tadashi
T
Kosugi
Shinichi
S
Nakagawa
Satoru
S
Hatakeyama
Katsuyoshi
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology*; D016019:Survival Analysis; D016896:Treatment Outcome