title: High survival in patients operated for small isolated liver metastases from gastric cancer: a multi-institutional study.
abstract: BACKGROUND
  Although several studies have reported the outcomes of surgery for the treatment of liver metastases of gastric cancer (GLM), indications for liver resection for gastric metastases remain controversial. This study was designed to identify prognostic determinants that identify operable hepatic metastases from gastric cancer and to evaluate the actual targets of surgical therapy.
  
  
  METHODS
  Retrospective analysis was performed on outcomes for 24 consecutive patients at five institutions who underwent gastrectomy for gastric cancer followed by curative hepatectomy for GLM between 2000 and June 2012.
  
  
  RESULTS
  Overall 5-year survival and median survival were 40.1 % and 22.3 months, respectively. Uni- and multivariate analyses showed that liver metastatic tumour size less than 5 cm was the most important predictor of overall survival (OS, p = 0.03). Four patients survived >5 years. Repeat hepatectomy was performed in three patients. Two of these patients have remained disease-free since the repeat hepatectomy.
  
  
  CONCLUSIONS
  GLM patients with metastatic tumour diameter less than 5 cm maximum are the best candidates for hepatectomy. Hepatic resection should be considered as an option for gastric cancer patients with liver metastases.
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan, sur115@poh.osaka-med.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Komeda
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Takuya
authors.initials: T
authors.lastname: Nakai
authors.forename: Masaki
authors.initials: M
authors.lastname: Kaibori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Chikato
authors.initials: C
authors.lastname: Koga
authors.forename: Masataka
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Tatsuma
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Hirokawa
authors.forename: A-Hon
authors.initials: AH
authors.lastname: Kwon
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D005743:Gastrectomy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D047368:Tumor Burden