[Two Cases of Gastric Cancer Accompanied by Simultaneous Liver Metastases Treated with Hepatectomy]

Case 1: Urgent examination of a 72‒year‒old man with hematemesis revealed a gastroesophageal tumor. Biopsy revealed gastric cancer, and computed tomography(CT)revealed enlarged lymph nodes and multiple liver metastases. Laparoscopic gastrectomy led to the diagnosis of a pT3N2M1(HEP), pStage Ⅳ liver tumor. A CT scan performed 2 months postoperatively revealed enlargement of the liver tumor, suggesting hepatocellular carcinoma and prompting right liver lobectomy. Histopathological examination of the operative specimen revealed metastatic hepatocellular carcinoma. Adjuvant chemotherapy(S‒1)was administered postoperatively but was discontinued because of severe adverse effects. To date, the patient has been recurrence‒free for 3 years. Case 2: A 79‒year‒old man with black stools who had not sought treatment presented to the emergency department with nausea and dizziness. A CT scan revealed a gastric mass, enlarged lymph nodes, and a liver tumor. After a thorough investigation, gastric cancer(cT4aN2M1[HEP], cStage ⅣB)was diagnosed. As the liver metastasis was solitary, pylorus‒preserving gastrectomy and partial hepatic resection were performed. Adjuvant chemotherapy(S‒1)was administered for 1 year, during which the patient remained recurrence‒free. Given that resection of liver metastases from gastric cancer often achieves long‒term survival, we performed this procedure as a component of multidisciplinary treatment.