Resection of liver metastases from gastric cancer: Remenecor project

The liver is one of the most frequent sites of metastatic spread in gastric cancer (GC). Although systemic chemotherapy remains the standard of care, surgical resection of liver metastases has demonstrated promising outcomes in carefully selected patients.

A retrospective, observational, multicentre study including all adult patients who underwent surgical treatment for GC liver metastases between January 2010 and December 2022 in Hepatobiliopancreatic Surgery units across Spain.

A total of 37 patients were analysed, predominantly male (73%), with a mean age of 64.1 years (SD: 13.2). Metachronous metastases were present in 73% of cases. Most procedures consisted of non-anatomical liver resections, performed via an open approach in 75.7% of patients. Negative surgical margins were achieved in 91.9% of resections. The rate of major postoperative complications was 29.6%, with an operative mortality of 2.7% and a mean postoperative hospital stay of 7.5 days. During follow-up, 64.9% of patients developed disease recurrence, predominantly within the liver. Median disease-free survival (DFS) was 14 months, and median overall survival (OS) was 40 months. The 1-, 3-, and 5-year DFS rates were 54.1%, 29.7%, and 24.3%, respectively, while the corresponding OS rates were 89.2%, 54.1%, and 37.8%. On multivariable Cox proportional hazards analysis, age, lymph node involvement, and metachronous resection were independently associated with an increased risk of death.

Hepatectomy in selected patients with liver metastases from GC may be associated with favourable long-term survival. These findings support a potential role for surgical resection within a multidisciplinary treatment strategy; however, well-defined selection criteria are essential to optimize patient outcomes.