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

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgments

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

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Nobuyuki Takemura, Akio Saiura, Rintaro Koga, Junichi Arita, Ryuji Yoshioka, Yoshihiro Ono, Naoki Hiki, Takeshi Sano & Toshiharu Yamaguchi

  2. Department of Surgery, National Defense Medical College, Tokorozawa, Japan

    Junji Yamamoto

  3. Division of Hepato–Biliary–Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Norihiro Kokudo

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  1. Nobuyuki Takemura
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  2. Akio Saiura
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  3. Rintaro Koga
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  5. Ryuji Yoshioka
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  9. Junji Yamamoto
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  10. Norihiro Kokudo
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Correspondence to Akio Saiura.

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Takemura, N., Saiura, A., Koga, R. et al. Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections. Langenbecks Arch Surg 397, 951–957 (2012). https://doi.org/10.1007/s00423-012-0959-z

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