title: Hepatectomy for liver metastases from gastric cancer: a systematic review.
abstract: BACKGROUND
  Official guidelines recommend palliative treatments for patients with liver metastases from gastric cancer. However, many case series reported that hepatectomy for such cases is safe and effective. This systematic review compares the overall survival between hepatectomy and palliative therapy in patients with liver metastases from gastric cancer.
  
  
  METHODS
  Two independent reviewers performed a systematic search of literature in EMBASE and PubMed, updated until 26 October 2016. The Newcastle-Ottawa score for cohort studies was used for quality assessment of included studies.
  
  
  RESULTS
  A total of eight cohort studies involving 196 patients in the hepatectomy arm and 481 in the palliative arm were included. Median overall survival of patients in the two arms was 23.7 (range, 13.0 to 48.0) and 7.6 (range, 5.5 to 15.2), respectively. Median rates of overall survival of the two arms were 69, 40, 33 and 27, 8, 4% at 1, 2, and 3 years, respectively. Comparing with palliative therapy, hepatectomy was associated with significantly lower mortality at 1 year (odds ratio 0.17, P < 0.001) and 2 years (odds ratio 0.15, P < 0.001). Among the patients who underwent hepatectomy, Asian cohorts showed higher median rates of overall survival than Western cohorts at 1 year (76 vs. 60%), 2 years (47 vs. 30%) and 3 years (39 vs. 23%).
  
  
  CONCLUSIONS
  Hepatectomy in the management of liver metastases from gastric cancer can be considered effective. In the elective setting, hepatectomy provides a potential alternative to palliative therapy.
authors.affiliation: Nutrition Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Ying-Yang
authors.initials: YY
authors.lastname: Liao
authors.affiliation: Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Province, China.
authors.forename: Ning-Fu
authors.initials: NF
authors.lastname: Peng
authors.affiliation: Colorectal Anal Surgery Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
authors.forename: Di
authors.initials: D
authors.lastname: Long
authors.affiliation: Colorectal Anal Surgery Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
authors.forename: Peng-Cheng
authors.initials: PC
authors.lastname: Yu
authors.affiliation: Colorectal Anal Surgery Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
authors.forename: Sen
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Province, China. zhongjianhong66@163.com.
authors.forename: Jian-Hong
authors.identifier: http://orcid.org/0000-0002-1494-6396
authors.initials: JH
authors.lastname: Zhong
authors.affiliation: Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Province, China.
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
mesh_terms: D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology*
keywords: Gastric cancer; Hepatectomy; Liver metastases; Systematic review