title: Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation.
abstract: BACKGROUND
  Although various liver-directed treatment modalities, such as liver resection and radiofrequency ablation (RFA), have been applied to treat liver metastases from gastric cancer, optimal management of them remains controversial. In patients with liver metastasis from gastric cancer, we investigated the short- and long-term outcomes of liver resection and RFA and analyzed factors influencing survival.
  
  
  METHODS
  A total of 98 gastric cancer patients with liver metastasis and no extrahepatic disease were treated by liver resection (n = 68) or RFA (n = 30). Short- and long-term outcomes were evaluated retrospectively for each of the liver-directed treatments.
  
  
  RESULTS
  Severe complication rates did not differ between liver resection (18 %) and RFA (10 %) (p = 0.333). Only one treatment-related mortality occurred in the liver resection group. No statistically significant difference in survival was noted between the treatment groups. Median overall survival after liver resection was 24 months, with 3-year overall and progression-free survival rates of 40.6 % and 30.4 %, respectively. Median overall survival after RFA was 23 months, with 3-year overall and progression-free survival rates of 43.0 % and 37.4 %, respectively. Only the size of the metastases was shown to be an independent prognostic factor for gastric cancer patients with liver metastasis.
  
  
  CONCLUSIONS
  In select patients with liver metastasis from gastric cancer, liver resection and RFA showed satisfactory and comparable short- and long-term results. Thus, systemic chemotherapy may not be the only therapeutic option for patients with liver metastasis, and possible liver-directed treatment options for such patients should be considered on an individual basis.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.|Department of General Surgery, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Guner
authors.affiliation: Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, South Korea.|Department of Surgery, Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea.
authors.forename: Taeil
authors.initials: T
authors.lastname: Son
authors.affiliation: Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, South Korea.|Department of Surgery, International St. Mary's Hospital, Incheon, South Korea.
authors.forename: In
authors.initials: I
authors.lastname: Cho
authors.affiliation: Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, South Korea.|Department of Surgery, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: In Gyu
authors.initials: IG
authors.lastname: Kwon
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Ji Yeong
authors.initials: JY
authors.lastname: An
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea.|Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Hyoung-Il
authors.initials: HI
authors.lastname: Kim
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Cheong
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea. wjhyung@yuhs.ac.|Gastric Cancer Center, Yonsei Cancer Hospital, Yonsei University Health System, Seoul, South Korea. wjhyung@yuhs.ac.|Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul, South Korea. wjhyung@yuhs.ac.
authors.forename: Woo Jin
authors.identifier: http://orcid.org/0000-0002-8593-9214
authors.initials: WJ
authors.lastname: Hyung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate
keywords: Gastric cancer; Liver metastasis; Liver resection; Prognosis; Radiofrequency ablation