Top

Published in:

01-07-2009 | Original Article

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

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

Published in: Langenbeck's Archives of Surgery | Issue 4/2009

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.

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

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

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 235:86–91PubMedCrossRef

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 55:2498–2505PubMedCrossRef

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 133:507–511PubMedCrossRef

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 181:279–283PubMedCrossRef

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 804–795PubMed

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 187:487–493PubMedCrossRef

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 121:625–632PubMedCrossRef

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 42:666–671PubMed

11.

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

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 32:587–593PubMedCrossRef

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 92:490–493PubMed

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 81:1175–1178PubMedCrossRef

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 1:10–24CrossRef

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 94:322–327PubMedCrossRef

18.

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

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 96:3178–3184PubMedCrossRef

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 181:153–159PubMedCrossRef

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 231:487–499PubMedCrossRef

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 221:74–78PubMedCrossRef

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 81:685–688PubMedCrossRef

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 117:380–385PubMedCrossRef

Title: Analysis of the prognostic factors and evaluation of surgical treatment for synchronous liver metastases from gastric cancer
Authors: Kentaro Ueda
Makoto Iwahashi
Mikihito Nakamori
Masaki Nakamura
Teiji Naka
Koichiro Ishida
Toshiyasu Ojima
Hiroki Yamaue
Publication date: 01-07-2009
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 4/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0311-9

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background and aims

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background and aims

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2009

Emergency spontaneous gastric perforations: ulcus versus cancer

Does tumor size have an impact on gastric cancer? A single institute experience

Esophageal resection for giant leiomyoma: report of two cases and a review of the literature

Microscopic cancer cell spread in gastric cancer: whole-section analysis of mesogastrium

External validation of a US-derived nomogram that predicts individual survival after gastric cancer resection

Which parameters are needed for targeting a multitined radiofrequency device—an approach to a simple algorithm