title: Hepatic resection for gastric cancer liver metastases: A systematic review and meta-analysis.
abstract: BACKGROUND
  Resection of liver metastases from gastric cancer (GC) is rarely performed, and the outcome after hepatic surgery has not been systematically evaluated in the literature. The aim of this study was to perform a systematic review of outcome and prognostic factors for survival after liver metastasectomy for GC.
  
  
  METHODS
  We performed a meta-analysis of published studies that focused on long-term outcomes (5-year overall survival [OS]) after surgical management of liver metastases from GC, and included more than 10 patients each. Pooled hazard ratios (HRs) were calculated for variables considered as potential prognostic factors for OS in at least three publications.
  
  
  RESULTS
  Twenty-three studies comprising a total of 870 patients were considered in this analysis. The pooled weighted median OS was 22 months (95%CI 17.6-27.2). The pooled 5-year OS after liver resection was 23.8% (95%CI 19-29.3%). The pooled 5-year OS rates for metachronous and synchronous metastases were 30% (95%CI 24.7-35.8%) and 22.6% (95%CI 14-34.4%), respectively. Parameters associated with poor survival were (i) multiple metastases, and (ii) large size of metastases.
  
  
  CONCLUSIONS
  Hepatic resection of GC liver metastases is associated with an acceptable 5-year OS, in particular after surgery of metachronous lesions, and could be offered to selected patients.
authors.affiliation: Department of Oncology, Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio (BG), Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Petrelli
authors.affiliation: Department of Oncology, Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio (BG), Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Coinu
authors.affiliation: Department of Oncology, Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio (BG), Italy.
authors.forename: Mary
authors.initials: M
authors.lastname: Cabiddu
authors.affiliation: Department of Oncology, Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio (BG), Italy.
authors.forename: Mara
authors.initials: M
authors.lastname: Ghilardi
authors.affiliation: Department of Oncology, Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio (BG), Italy.
authors.forename: Karen
authors.initials: K
authors.lastname: Borgonovo
authors.affiliation: Department of Oncology, Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio (BG), Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Lonati
authors.affiliation: Department of Oncology, Division of Medical Oncology, Azienda Ospedaliera Treviglio, Treviglio (BG), Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
mesh_terms: D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D059146:Metastasectomy; D009378:Neoplasms, Multiple Primary / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000601:surgery; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology*; D016019:Survival Analysis
keywords: 5-year survival; gastric cancer; liver metastases; meta-analysis; surgery