title: Liver resection for gastric cancer metastases.
abstract: OBJECTIVE
  Surgical indications in patients with liver metastases from gastric cancer are debated. To analyze outcomes of surgery and the impact of neoadjuvant chemotherapy (NeoCTx).
  
  
  METHODS
  Consecutive patients undergoing liver resection for gastric metastases between January 1997 and December 2008 were analyzed.
  
  
  RESULTS
  Liver metastases were synchronous in 9 patients and multiple in 5. Eight patients received NeoCTx. NeoCTx and non-NeoCTx groups had similar characteristics. Mortality was nil, morbidity was 40%. After a mean follow-up of 42.5 months, 5-year survival rate was 33.2%. Presence of multiple metastases was a negative prognostic factor (p=0.029), while synchronous presentation and NeoCTx were not. Disease-free survival rates were significantly different by stratifying patients according to response to chemotherapy: at 5 years 32.4% in non-NeoCTx group, 0% in disease progression (PD) while on NeoCTx group and 60.0% in non-PD while on NeoCTx group (p=0.018). One-year recurrence rates were 40%, 100% and 0%, (p=0.020).
  
  
  CONCLUSIONS
  Liver resection for gastric metastases achieves good long-term results, especially in solitary metastases. NeoCTx helps to select candidates for surgery and, in patients without PD, is associated with improved disease-free survival
authors: Department of HPB and Digestive Surgery, Ospedale Mauriziano Umberto I, Torino, Italy. lvigano@ymail.com
authors: Luca
authors: L
authors: Viganò
authors: Maria
authors: M
authors: Vellone
authors: Alessandro
authors: A
authors: Ferrero
authors: Felice
authors: F
authors: Giuliante
authors: Gennaro
authors: G
authors: Nuzzo
authors: Lorenzo
authors: L
authors: Capussotti
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018579:Patient Selection; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome