title: Treatment outcomes of hepatectomy for liver metastases of gastric cancer diagnosed using contrast-enhanced magnetic resonance imaging.
abstract: BACKGROUND
  Chemotherapy is the standard treatment for liver metastases of gastric cancer (LMGC). Hepatectomy for LMGC reportedly has a 5-year survival rate of 13-37 %; however, its significance has not been established. At our hospital, hepatectomy is performed for patients with three or fewer metastases diagnosed using contrast-enhanced magnetic resonance imaging (MRI). To identify the ideal patient subpopulation for resection, we retrospectively analyzed treatment outcomes in patients with LMGC who underwent hepatectomy.
  
  
  METHODS
  Clinicopathological factors affecting survival were explored using univariate and multivariate analyses in 28 patients who underwent hepatectomy for LMGC diagnosed using contrast-enhanced MRI between December 2004 and October 2014.
  
  
  RESULTS
  The study included 23 men and 5 women with a median age of 72 years. Metastases were synchronous in 15 patients and metachronous in 13 patients. The median overall survival time was 49 months, with a 5-year survival rate of 32 %. Univariate analysis revealed that overall survival time was shorter in the presence of the following factors: age ≥70 years (p = 0.030), synchronous liver metastases (p = 0.017), and presence of postoperative complications (p = 0.042). In patients with metachronous liver metastases, the post-resection 5-year survival rate was 59 %.
  
  
  CONCLUSIONS
  The 5-year survival rate was 32 % in patients who underwent hepatectomy for LMGC according to our criteria, suggesting that hepatectomy is an important treatment if indications are on the basis of contrast-enhanced MRI. Therefore, active resection should be considered, particularly for patients with metachronous liver metastases.
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Tatsubayashi
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tanizawa
authors.affiliation: Department of Surgical Oncology Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Miki
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Tokunaga
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Etsuro
authors.initials: E
authors.lastname: Bando
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Taiichi
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: Division of Gastrointestinal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Teiichi
authors.initials: T
authors.lastname: Sugiura
authors.affiliation: Division of Gastrointestinal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kinugasa
authors.affiliation: Division of Gastrointestinal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Uesaka
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. m.terashima@scchr.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Terashima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000401:mortality*; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: Gastric cancer; Hepatectomy; Liver metastasis