title: A case with synchronous multiple liver metastases from gastric carcinoma: postoperative long-term disease-free survival.
abstract: OBJECTIVE
  We herein report a case with synchronous multiple liver metastases from gastric carcinoma surviving disease-free for more than 10 years after hepatic resection.
  
  
  METHODS
  A 64-year-old male admitted to our hospital because of constitutional wariness. Preoperative diagnosis was type 1 gastric cancer at the lower third of the stomach and multiple metastases of both hepatic lobes. After we performed distal gastrectomy with regional lymphadenectomy and wedge hepatic resection for eight metastatic liver tumors, he received 5-fluoropyrimidine and platinum-based adjuvant chemotherapy during the early postoperative period.
  
  
  RESULTS
  The pathologic examination revealed moderately differentiated gastric adenocarcinoma with regional lymph node metastasis and multiple liver metastases. The postoperative course was uneventful and the patient is doing well without disease recurrence after more than 10 years following surgery.
  
  
  CONCLUSIONS
  To the best of our knowledge, this patient is the longest disease-free survivor after liver resection for synchronous multiple liver metastases from advanced gastric cancer. In this modern era of developing liver surgery and adjuvant chemotherapy, combination therapy of aggressive surgery and early postoperative adjuvant chemotherapy for advanced gastric cancer with liver metastasis may allow long-term survival in selected patients.
authors.affiliation: Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi, 783-8505, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Munekage
authors.forename: Takehiro
authors.initials: T
authors.lastname: Okabayashi
authors.forename: Norihiro
authors.initials: N
authors.lastname: Hokimoto
authors.forename: Takeki
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Maeda
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.forename: Ken
authors.initials: K
authors.lastname: Dabanaka
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Keijiro
authors.initials: K
authors.lastname: Araki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005743:Gastrectomy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013997:Time Factors
chemical_list: D011743:Pyrimidines; C029269:5-fluoropyrimidine