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Surgical treatment for gastric carcinomas with concomitant hepatic metastasis
A Saito1, D Korenaga, Y Sakaguchi
1Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Background/Aims:
We have reviewed our experience with gastric cancer patients having synchronous liver metastasis in an attempt to clarify how to treat such patients.
Patients And Methods:
In 116 patients with gastric cancer metastatic to the liver, evaluations were executed to find an effective treatment. Fourteen received gastrectomy plus hepatic resection (Group A), 68 gastrectomy alone (Group B), and 34 non-resected (Group C).
Results:
The average survival time was 15.0 months in Group A, 7.2 months in Group B and 3.6 months in Group C, with a statistical difference between Group B and Group C (p < 0.05). In Group A patients, the mean survival time was 21.5 months in those undergoing potentially curative surgery for the carcinoma without incurable factors other than liver metastasis. The survival time was 6.3 months in those undergoing noncurative gastrectomy and hepatectomy because of evidence of incurable metastatic spread, the value being similar to that following gastrectomy alone in Group B patients. In Group B, adjuvant chemotherapy led to a significant increase in survival (p < 0.05).
Conclusions:
Hepatectomy combined with gastrectomy seems to be effective as an active measure to lengthen survival for patients of gastric carcinoma and concomitant liver metastasis only when other incurable factors were not evident at operation. Noncurative gastrectomy followed by adjuvant chemotherapy is recommended in the presence of various incurable factors.