Yazawa T, Hori T, Yamamoto H, Harada H, Yamamoto M, Yamada M, Tani M, Sato A, Kamada Y, Tani R, Aoyama R, Sasaki Y, Zaima M. Do liver metastases from gastric cancer contraindicate aggressive surgical resection? A 14-year single-center experience. World J Gastrointest Pharmacol Ther 2020; 11(5): 110-122 [PMID: 33251035 DOI: 10.4292/wjgpt.v11.i5.110]
Corresponding Author of This Article
Tomohide Hori, FACS, MD, PhD, Associate Professor, Attending Doctor, Doctor, Surgeon, Department of Surgery, Shiga General Hospital, 5-4-30 Moriyama, Moriyama 524-8524, Shiga, Japan. horitomo55office@yahoo.co.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Takefumi Yazawa, Tomohide Hori, Hidekazu Yamamoto, Hideki Harada, Michihiro Yamamoto, Masahiro Yamada, Masaki Tani, Asahi Sato, Yasuyuki Kamada, Ryotaro Tani, Ryuhei Aoyama, Yudai Sasaki, Masazumi Zaima, Department of Surgery, Shiga General Hospital, Moriyama 524-8524, Shiga, Japan
Author contributions: Yazawa T collected the data; Yazawa T and Hori T analyzed the data and wrote this report; Yazawa T and Hori T contributed equally to this work; Zaima M and Hori T supervised this report; all authors discussed therapeutic options, reviewed previous papers, and provided important opinions.
Institutional review board statement: This report was approved by the Institutional Review Board of Shiga General Hospital, Moriyama, Japan.
Informed consent statement: The patients involved in this study provided written informed consent authorizing the use and disclosure of their protected health information.
Conflict-of-interest statement: Neither author has a potential conflict of interest.
Data sharing statement: Data in this report were retrospectively evaluated.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tomohide Hori, FACS, MD, PhD, Associate Professor, Attending Doctor, Doctor, Surgeon, Department of Surgery, Shiga General Hospital, 5-4-30 Moriyama, Moriyama 524-8524, Shiga, Japan. horitomo55office@yahoo.co.jp
Received: March 4, 2020 Peer-review started: March 4, 2020 First decision: April 12, 2020 Revised: April 27, 2020 Accepted: September 1, 2020 Article in press: September 1, 2020 Published online: November 8, 2020 Processing time: 247 Days and 4.6 Hours
ARTICLE HIGHLIGHTS
Research background
Advanced gastric cancer (GC) often accompanies with liver metastasis. Though many physicians consider that radical surgeries are contraindicated for liver metastases from GC (LMGC). a smaller number of liver metastases without unresectable factors may be an indication for liver resection (LR).
Research motivation
The actual 5-year overall survival (OS) rate was previously documented as 0 to 0.37. Here, we presented the institutional indications for LR for LMGC, evaluated our own results.
Research objectives
In total, 30 patients underwent LR for LMGC during a 14-year period, and we evaluated the clinical, surgical, and oncological findings.
Research methods
In all patients, radical surgery with intentional lymphadenectomy was performed for the primary GC. The median follow-up duration after the initial LR was 33.7 mo. The OS and recurrence-free survival rates after the initial LR were assessed. Also, we identified important factors for prognostic outcomes.
Research results
The 5-year OS and recurrence-free survival rates were 0.48 and 0.28, respectively. The median survival duration and recurrence-free duration after the initial LR were 16.8 and 8.6 mo, respectively. Although recurrence might develop after the initial LR, additional surgeries for recurrence clearly prolong survival. Pathological serosal invasion was an independent predictor of a poor prognostic outcome after the initial LR.
Research conclusions
Our results of LR for LMGC seem acceptable. Pathological serosal invasion is important for poor prognostic outcomes.
Research perspectives
Aggressive LR may be indicated for carefully selected patients with LMGC.
