Prognostic analysis of combined curative resection of the stomach and liver lesions in 30 gastric cancer patients with synchronous liver metastases.
BACKGROUND
Gastric cancer with synchronous liver metastasis remains a clinical treatment challenge. There has been a longstanding debate on the question whether surgical resection could be beneficial to long-term survival. This study is to investigate the effectiveness and prognostic factors of combined curative resection of the stomach and liver lesions in gastric cancer patients with synchronous liver metastases.


METHODS
A total of 30 patients who underwent simultaneous curative gastric and liver resection from March 2003 to April 2008 were analyzed retrospectively. Univariate and multivariate analyses were performed to select independent factors for survival.


RESULTS
The overall 1-, 2-, 3- and 5-year survival rates of 30 patients were 43.3%, 30.0%, 16.7% and 16.7%, respectively, with a median survival of 11.0 months and 5 patients still living by the time of last follow-up. Single liver metastasis (p=0.028) and an absence of peritoneal dissemination (p=0.007) were significantly independent prognostic factors for these gastric cancer patients with synchronous liver metastases. Major adverse events were protracted stomach paralysis in 2 patients and pulmonary infection in another 2 patients, all of whom recovered after conservative treatment.


CONCLUSIONS
This descriptive study without control group found that patients with solitary liver metastasis and absence of peritoneal dissemination could have better survival benefit from simultaneous curative resection of the gastric cancer and liver metastases.
Department of General Surgery, Zhongshan Hospital of Fudan University, No 180 Fenglin Road, Shanghai, 200032, China.
Yan-Na
YN
Wang
Kun-Tang
KT
Shen
Jia-Qian
JQ
Ling
Xiao-Dong
XD
Gao
Ying-Yong
YY
Hou
Xue-Fei
XF
Wang
Jing
J
Qin
Yi-Hong
YH
Sun
Xin-Yu
XY
Qin
D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D010534:Peritoneal Neoplasms / Q000556:secondary; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000601:surgery*; D015996:Survival Rate