title: Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302).
abstract: BACKGROUND
  The necessity of surgical treatment of liver metastases of gastric cancer is still controversial.
  
  
  METHODS
  We conducted a multicenter retrospective cohort study of liver-limited metastasis of gastric cancer treated surgically between 2000 and 2010. In this study, 103 patients were registered, with nine patients excluded from the analysis as they did not meet the eligibility criteria.
  
  
  RESULTS
  Of the 94 patients, 69 underwent surgical resection, 11 underwent surgical resection combined with radiofrequency ablation or microwave coagulation therapy for small or deep tumors, and 14 underwent radiofrequency ablation or microwave coagulation therapy only. Synchronous and metachronous metastases were found in 37 and 57 patients, respectively. The 3- and 5-year overall survival rates of all the patients were 51.4 and 42.3 %, respectively. The 3- and 5-year relapse-free survival rates were 29.2 and 27.7 %, respectively. No significant difference in prognosis was observed between the patients who underwent surgical resection and those who underwent ablation therapy. The patients with hepatic solitary lesions and low-grade lymph node metastases of primary gastric cancer had significantly better overall survival and relapse-free survival.
  
  
  CONCLUSIONS
  To our knowledge, this study is the largest series and first multicenter cohort study of liver-limited metastasis of gastric cancer. The study indicated that patients with a single liver metastasis with a grade lower than N2 lymph node metastasis of the primary lesion are the best candidates for liver resection.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan. okieiji@surg2.med.kyushu-u.ac.jp.
authors.forename: Eiji
authors.initials: E
authors.lastname: Oki
authors.affiliation: Medical Information Center, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Tokunaga
authors.affiliation: Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Emi
authors.affiliation: Department of Gastroenterological Surgery/Clinical Research Institute Cancer Research Division, National Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kusumoto
authors.affiliation: Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Surgery, Oita Red Cross Hospital, Oita, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Fukuzawa
authors.affiliation: Department of Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Takahashi
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.affiliation: Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Tsuji
authors.affiliation: Department of Surgery, Steel Memorial Yawata Hospital, Kitakyushu, Japan.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Higashi
authors.affiliation: Department of Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saeki
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kakeji
authors.affiliation: Department of Medical Oncology, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakai
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
authors.affiliation: Division of Digestive and General Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nishimaki
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate
keywords: Gastric cancer; Hepatectomy; Liver metastasis; Radiofrequency ablation