Skip to main content

Advertisement

SpringerLink
Log in

Analysis of the prognostic factors and evaluation of surgical treatment for synchronous liver metastases from gastric cancer

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background and aims

Whether or not a synchronous resection of liver metastases from gastric cancer provides a survival benefit has been a key issue. We identify the significant prognostic factors and clarify the beneficial effect on the survival of liver surgical treatment.

Materials and methods

We reviewed 72 patients who underwent a gastrectomy for gastric cancer with synchronous liver metastases and classified the liver metastases into three grades, such as H1: metastases were limited to one of the lobes, H2: there were a few scattered metastases in both lobes, and H3: there were numerous scattered metastases.

Results

H1, 2 metastases, and an absence of peritoneal dissemination (P0) were significantly independent prognostic factors for liver metastases of gastric cancer. In addition, the cumulative 1 and 5-year survival rates of liver surgical treatment (hepatic resection and/or microwave coagulation therapy) were 80.0% and 60.0%, whereas the survival rates for non-hepatic surgical treatment were 36.4% and 0% in 26 patients with H1, 2, and P0. In those patients, the radical operation, the solitary metastatic liver tumor, and no-distant lymph node metastases were independent prognostic determinants of survival.

Conclusion

The radical operation including the surgical treatment for metastatic liver tumors should be performed to improve the prognosis in gastric cancer patients with synchronous H1, 2, and P0.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Dicken BJ, Bigam DL, Cass C, Mackey JR, Joy AA, Hamilton SM (2005) Gastric adenocarcinoma: review and considerations for future directions. Ann Surg 241:27–39

    PubMed  Google Scholar 

  2. Fujisaki S, Tomita R, Nezu T, Kimizuka K, Park E, Fukuzawa M (2001) Prognostic studies on gastric cancer with concomitant liver metastases. Hepatogastroenterology 48:892–894

    PubMed  CAS  Google Scholar 

  3. Okano K, Maeba T, Ishimura K, Karasawa Y, Goda F, Wakabayashi H, Usuki H, Maeta H (2002) Hepatic resection for metastatic tumors from gastric cancer. Ann Surg 235:86–91

    Article  PubMed  Google Scholar 

  4. Okuyama K, Isono K, Juan IK, Onoda S, Ochiai T, Yamamoto Y, Koide Y, Satoh H (1985) Evaluation of treatment for gastric cancer with liver metastasis. Cancer 55:2498–2505

    Article  PubMed  CAS  Google Scholar 

  5. Sakamoto Y, Ohyama S, Yamamoto J, Yamada K, Seki M, Ohta K, Kokudo N, Yamaguchi T, Muto T, Makuuchi M (2003) Surgical resection of liver metastases of gastric cancer: an analysis of a 17-year experience with 22 patients. Surgery 133:507–511

    Article  PubMed  Google Scholar 

  6. Ambiru S, Miyazaki M, Ito H, Nakagawa K, Shimizu H, Yoshidome H, Shimizu Y, Nakajima N (2001) Benefits and limits of hepatic resection for gastric metastases. Am J Surg 181:279–283

    Article  PubMed  CAS  Google Scholar 

  7. Bines SD, England G, Deziel DJ, Witt TR, Doolas A, Roseman DL (1993) Synchronous, metachronous, and multiple hepatic resections of liver tumors originating from primary gastric tumors. Surgery 114:799–805 discussion 804–795

    PubMed  CAS  Google Scholar 

  8. Elias D, Cavalcanti de Albuquerque A, Eggenspieler P, Plaud B, Ducreux M, Spielmann M, Theodore C, Bonvalot S, Lasser P (1998) Resection of liver metastases from a noncolorectal primary: indications and results based on 147 monocentric patients. J Am Coll Surg 187:487–493

    Article  PubMed  CAS  Google Scholar 

  9. Harrison LE, Brennan MF, Newman E, Fortner JG, Picardo A, Blumgart LH, Fong Y (1997) Hepatic resection for noncolorectal, nonneuroendocrine metastases: a fifteen-year experience with ninety-six patients. Surgery 121:625–632

    Article  PubMed  CAS  Google Scholar 

  10. Rafique M, Adachi W, Kajikawa S, Kobayashi M, Koike S, Kuroda T (1995) Management of gastric cancer patients with synchronous hepatic metastasis: a retrospective study. Hepatogastroenterology 42:666–671

    PubMed  CAS  Google Scholar 

  11. Schwartz SI (1995) Hepatic resection for noncolorectal nonneuroendocrine metastases. World J Surg 19:72–75

    Article  PubMed  CAS  Google Scholar 

  12. Kunieda K, Saji S, Sugiyama Y, Osada S, Sano J, Nagao N, Takahashi T, Takagi Y, Arai Y (2002) Evaluation of treatment for synchronous hepatic metastases from gastric cancer with special reference to long-term survivors. Surg Today 32:587–593

    Article  PubMed  Google Scholar 

  13. Miyazaki M, Itoh H, Nakagawa K, Ambiru S, Shimizu H, Togawa A, Shiobara M, Ohtsuka M, Sasada K, Shimizu Y, Yoshioka S, Nakajima N, Suwa T, Kimura F (1997) Hepatic resection of liver metastases from gastric carcinoma. Am J Gastroenterol 92:490–493

    PubMed  CAS  Google Scholar 

  14. Ochiai T, Sasako M, Mizuno S, Kinoshita T, Takayama T, Kosuge T, Yamazaki S, Maruyama K (1994) Hepatic resection for metastatic tumours from gastric cancer: analysis of prognostic factors. Br J Surg 81:1175–1178

    Article  PubMed  CAS  Google Scholar 

  15. Japanese Research Society for Gastric Cancer (ed) (1995) Japanese classification of gastric carcinoma. First English edition. Kanehara & Co, Ltd: Tokyo

  16. Japanese Gastric Cancer A (1998) Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer 1:10–24

    Article  Google Scholar 

  17. Seki T, Wakabayashi M, Nakagawa T, Imamura M, Tamai T, Nishimura A, Yamashiki N, Inoue K (1999) Percutaneous microwave coagulation therapy for solitary metastatic liver tumors from colorectal cancer: a pilot clinical study. Am J Gastroenterol 94:322–327

    Article  PubMed  CAS  Google Scholar 

  18. Shibata T, Niinobu T, Ogata N, Takami M (2000) Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma. Cancer 89:276–284

    Article  PubMed  CAS  Google Scholar 

  19. Imamura H, Matsuyama Y, Shimada R, Kubota M, Nakayama A, Kobayashi A, Kitamura H, Ikegami T, Miyagawa SI, Kawasaki S (2001) A study of factors influencing prognosis after resection of hepatic metastases from colorectal and gastric carcinoma. Am J Gastroenterol 96:3178–3184

    Article  PubMed  CAS  Google Scholar 

  20. Kokudo N, Tada K, Seki M, Ohta H, Azekura K, Ueno M, Matsubara T, Takahashi T, Nakajima T, Muto T (2001) Anatomical major resection versus nonanatomical limited resection for liver metastases from colorectal carcinoma. Am J Surg 181:153–159

    Article  PubMed  CAS  Google Scholar 

  21. Minagawa M, Makuuchi M, Torzilli G, Takayama T, Kawasaki S, Kosuge T, Yamamoto J, Imamura H (2000) Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer: long-term results. Ann Surg 231:487–499

    Article  PubMed  CAS  Google Scholar 

  22. Yamamoto J, Sugihara K, Kosuge T, Takayama T, Shimada K, Yamasaki S, Sakamoto M, Hirohashi S (1995) Pathologic support for limited hepatectomy in the treatment of liver metastases from colorectal cancer. Ann Surg 221:74–78

    Article  PubMed  CAS  Google Scholar 

  23. Heys SD, Sherif A, Bagley JS, Brittenden J, Smart C, Eremin O (1994) Prognostic factors and survival of patients aged less than 45 years with colorectal cancer. Br J Surg 81:685–688

    Article  PubMed  CAS  Google Scholar 

  24. Maehara Y, Oshiro T, Baba H, Ohno S, Kohnoe S, Sugimachi K (1995) Lymphatic invasion and potential for tumor growth and metastasis in patients with gastric cancer. Surgery 117:380–385

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama, 641-8510, Japan

    Kentaro Ueda, Makoto Iwahashi, Mikihito Nakamori, Masaki Nakamura, Teiji Naka, Koichiro Ishida, Toshiyasu Ojima & Hiroki Yamaue

Authors
  1. Kentaro Ueda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Makoto Iwahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mikihito Nakamori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masaki Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Teiji Naka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Koichiro Ishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Toshiyasu Ojima
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hiroki Yamaue
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroki Yamaue.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ueda, K., Iwahashi, M., Nakamori, M. et al. Analysis of the prognostic factors and evaluation of surgical treatment for synchronous liver metastases from gastric cancer. Langenbecks Arch Surg 394, 647–653 (2009). https://doi.org/10.1007/s00423-008-0311-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-008-0311-9

Keywords

Search

Navigation