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Prognostic studies on gastric cancer with concomitant liver metastases
1First Department of Surgery, Nihon University School of Medicine, 30-1, Oyaguchikamimachi, Itabashi-ku, Tokyo 173, Japan. sfujisak@med.nihon-u.ac.jp
Background/Aims:
The aim of this study was to clarify prognostic factors after surgical treatments in gastric cancer patients having synchronous liver metastases.
Methodology:
Clinicopathological features and prognosis were retrospectively reviewed in 43 surgical patients with gastric cancer with concomitant liver metastases from 1984 to 1998.
Results:
More than half of the patients (51.2%) had numerous liver metastases (H3). Rates of peritoneal metastases (P1, P2, P3: 34.9%), tumor serosal invasion (T3 or T4: 73.8%) and widespread lymph node metastases (N3, N4: 69.8%) were also high. Although the gastric resection was performed in 29 patients (67.5%), concomitant hepatectomy resection was performed in only 3 patients (7.0%). Univariate analysis revealed that the grade of liver metastases (H1, H2, H3) was only a statistically significant prognostic factor (P = 0.008). Concerning surgical treatments, the resection group had tendency to better survival than the nonresection group (P = 0.074). Eight cases survived more than 1 year. Seven of the 8 cases (87.5%) were patients with gastrectomy. All of the 5 two-year survivors were patients with gastrectomy.
Conclusions:
In patients with gastric cancer with concomitant liver metastases, the grade of liver metastases indicate prognosis. In addition, there is possibility of palliative gastrectomy increasing the survival rare to more than one year.