Langenbeck's Archives of Surgery

, Volume 397, Issue 6, pp 951–957 | Cite as

Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections

  • Nobuyuki Takemura
  • Akio Saiura
  • Rintaro Koga
  • Junichi Arita
  • Ryuji Yoshioka
  • Yoshihiro Ono
  • Naoki Hiki
  • Takeshi Sano
  • Junji Yamamoto
  • Norihiro Kokudo
  • Toshiharu Yamaguchi
Original Article



The indication for hepatectomy in cases of gastric cancer liver metastases (GLM) remains unclear and it remains controversial whether surgical resection is beneficial for GLM. The objective of this retrospective study was to clarify the indications for and benefit of hepatectomy for GLM.


Seventy-three patients underwent hepatectomies for GLM from January 1993 to January 2011. Macroscopically complete (R0 or R1) resection was achieved in 64 patients. Among them, 32 patients underwent synchronous hepatectomy with gastrectomy and the remaining 32 patients underwent metachronous hepatectomy. Repeat hepatectomy was done in 14 patients for resectable intrahepatic recurrences. Clinicopathological factors were evaluated by univariate and multivariate analyses among patients who received macroscopically complete resection for those affecting survival.


The overall 1-, 3-, and 5-year survival rates after macroscopically complete (R0 or R1) liver resection (n = 64) for GLM were 84, 50, and 37 %, respectively, with a median survival of 34 months. Univariate analysis identified serosal invasion of the primary gastric cancer and blood transfusions during surgery as poor prognosis indicators. By multivariate analysis, serosal invasion of the primary gastric cancer and larger hepatic tumor (>5 cm in diameter) were found to be independent indicators of poor prognosis.


GLM patients with the maximum diameter of hepatic tumors of <5 cm and without serosal invasion of the primary gastric cancer are the best candidate for hepatectomy.


Gastric cancer liver metastasis (GLM) Prognosis Liver resection 



This work was supported in part by the National Cancer Center Research and Development Fund (23-A-14).

Conflicts of interest



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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Nobuyuki Takemura
    • 1
  • Akio Saiura
    • 1
  • Rintaro Koga
    • 1
  • Junichi Arita
    • 1
  • Ryuji Yoshioka
    • 1
  • Yoshihiro Ono
    • 1
  • Naoki Hiki
    • 1
  • Takeshi Sano
    • 1
  • Junji Yamamoto
    • 2
  • Norihiro Kokudo
    • 3
  • Toshiharu Yamaguchi
    • 1
  1. 1.Department of Gastroenterological Surgery, Cancer Institute Ariake HospitalJapanese Foundation for Cancer ResearchKoto-ku, TokyoJapan
  2. 2.Department of SurgeryNational Defense Medical CollegeTokorozawaJapan
  3. 3.Division of Hepato–Biliary–Pancreatic Surgery, Department of Surgery, Graduate School of MedicineUniversity of TokyoTokyoJapan

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