title: Hepatic resection for synchronous hepatic metastasis from gastric cancer.
abstract: BACKGROUND
  The role of surgical resection for synchronous hepatic metastases arising from gastric adenocarcinoma has not been established. This study was designed to explore the clinicopathologic features and surgical results of these patients.
  
  
  METHODS
  Twenty-five (4.8%) of 526 patients diagnosed with synchronous hepatic metastatic gastric cancer received hepatectomy and gastrectomy at the same time; 2 cases underwent repeat hepatectomy after intrahepatic recurrence. Clinicopathologic parameters of the hepatic metastases and the surgical results for all 25 patients were analysed.
  
  
  RESULTS
  The 1-, 3-, and 5-year overall survival (OS) and recurrence-free survival (RFS) rates after resection were 96.0%, 70.4%, and 29.4%, respectively, and 56.0%, 22.3%, and 11.1%, respectively. Five patients survived for more than 5 years after surgery, and no mortality has occurred within 30 days after resection. Univariate analysis revealed that patients with multiple hepatic metastases suffered poorer OS (P = 0.026) and RFS (P = 0.035) than those with solitary hepatic metastasis. Postoperative adjuvant chemotherapy was a significant indicator of a favourable OS (P = 0.022). Number of metastatic lesions remained significant in the multivariate analysis of OS and RFS (P = 0.039, P = 0.049, respectively). None of variables of the primary lesion was a significant prognostic factor for those patients.
  
  
  CONCLUSIONS
  Gastric cancer patients with a solitary synchronous liver metastasis may be good candidates for hepatic resection. Postoperative adjuvant chemotherapy may provide a benefit by aiding in OS.
authors.affiliation: State Key Laboratory of Oncology in South China and Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China.
authors.forename: J-L
authors.initials: JL
authors.lastname: Qiu
authors.forename: M-G
authors.initials: MG
authors.lastname: Deng
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.forename: R-H
authors.initials: RH
authors.lastname: Zou
authors.forename: B-K
authors.initials: BK
authors.lastname: Li
authors.forename: Y
authors.initials: Y
authors.lastname: Zheng
authors.forename: X-M
authors.initials: XM
authors.lastname: Lao
authors.forename: K
authors.initials: K
authors.lastname: Zhou
authors.forename: Y-F
authors.initials: YF
authors.lastname: Yuan
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D017024:Chemotherapy, Adjuvant; D002681:China; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods / Q000401:mortality; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods / Q000401:mortality; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D017741:Survivors; D016896:Treatment Outcome