[A case experienced long-term survival after repeat hepatectomy for liver metastases from gastric cancer]

Although the standard treatment for liver metastasis from gastric cancer is chemotherapy, there are several reports demonstrating better survival after hepatectomy. However, repeat hepatectomy for liver metastasis is still rare. We present a case of long-term survival after repeat hepatectomy for liver metastasis from gastric cancer. A 68-year-old male underwent distal gastrectomy with D2 lymphadenectomy for a gastric cancer. The histopathological finding revealed that the tumor was a moderately-differentiated tubular adenocarcinoma 43mm in diameter, with invasion to subserosa(T3; SS). There was one metastasis to the regional lymph node(#11p). The tumor was classified as T3N1M0(stage II B)according to the 14th edition of the Japanese Classification of Gastric Carcinoma. Fourteen months after the operation, computed tomography revealed two metastases in the lateral segment of the liver. He underwent left lateral segmentectomy followed by adjuvant chemotherapy with S-1(100mg)for one year. Sixteen months after the hepatectomy, a solitary hepatic metastasis 30mm in size at segment 8 was found by follow-up CT scan. He underwent repeat hepatectomy. He is free of recurrence now without adjuvant chemotherapy four years after repeat hepatectomy.