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Prognostic significance of radical surgical treatment for gastric cancer patients with synchronous liver metastases

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Abstract

It has been widely accepted that radical resection is the primary consideration to improve the survival rate for gastric cancer, but it is still controversial whether surgery could bring any substantial survival benefit to gastric cancer patients with synchronous liver metastasis. We retrospectively analyzed pathological and clinical data of 39 gastric patients with liver metastasis who underwent gastric–hepatic radical resection to explore the related prognostic factors. In the whole group of 39 patients, 1-, 2-, 3- and 5-year RFS rates were 30.8, 12.8, 10.3 and 7.7 %; 1-, 2-, 3- and 5-year overall survival (OS) rates were 56.4, 25.6, 17.9 and 10.3 %, respectively. Compared with patients without surgery, operative ones had a statistically significant long-term survival rate. With univariate analysis, lymph node metastasis (N stage), soft tissue invasion and number of liver metastases were significant prognostic factors associated with OS time of synchronous liver metastasis after radical gastrectomy (P < 0.05). What is more, N stage and number of liver metastases were independent factors associated with OS in multivariate analysis. For gastric adenocarcinoma with liver metastases, surgery maybe a superior option if complete resection of gastric and hepatic lesions is feasible and careful postoperative supporting treatment could be received at the same time, especially ones who had less number of liver metastases.

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References

  1. Lin Y, Ueda J, Kikuchi S, Totsuka Y, Wei WQ, Qiao YL, et al. Comparative epidemiology of gastric cancer between Japan and China. World J Gastroenterol. 2011;17(39):4421–8.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.

    Article  PubMed  Google Scholar 

  3. Liu J, Chen L. Current status and progress in gastric cancer with liver metastasis. Chin Med J (Engl). 2011;124(3):445–56.

    PubMed  Google Scholar 

  4. Schlansky B, Sonnenberg A. Epidemiology of noncardia gastric adenocarcinoma in the United States. Am J Gastroenterol. 2011;106(11):1978–85.

    Article  PubMed  Google Scholar 

  5. Shin A, Kim J, Park S. Gastric cancer epidemiology in Korea. J Gastric Cancer. 2011;11(3):135–40.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Chen J, Tang Z, Dong X, Gao S, Fang H, Wu D, et al. Radiofrequency ablation for liver metastasis from gastric cancer. Eur J Surg Oncol. 2013;39(7):701–6.

    Article  PubMed  CAS  Google Scholar 

  7. Vogl TJ, Gruber-Rouh T, Eichler K, Nour-Eldin NE, Trojan J, Zangos S, et al. Repetitive transarterial chemoembolization (TACE) of liver metastases from gastric cancer: local control and survival results. Eur J Radiol. 2013;82(2):258–63.

    Article  PubMed  Google Scholar 

  8. Jeurnink SM, van Eijck CH, Steyerberg EW, Kuipers EJ, Siersema PD. Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. BMC Gastroenterol. 2007;7(18):18.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kim TO, Kang DH, Kim GH, Heo J, Song GA, Cho M, et al. Self-expandable metallic stents for palliation of patients with malignant gastric outlet obstruction caused by stomach cancer. World J Gastroenterol. 2007;13(6):916–20.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kim MM, Rana V, Janjan NA, Das P, Phan AT, Delclos ME, et al. Clinical benefit of palliative radiation therapy in advanced gastric cancer. Acta Oncol. 2008;47(3):421–7.

    Article  PubMed  Google Scholar 

  11. Yin Z, Liu C, Chen Y, Bai Y, Shang C, Yin R, et al. Timing of hepatectomy in resectable synchronous colorectal liver metastases (SCRLM): simultaneous or delayed? Hepatology. 2013;57(6):2346–57.

    Article  PubMed  Google Scholar 

  12. Cheon SH, Rha SY, Jeung HC, Im CK, Kim SH, Kim HR, et al. Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases. Ann Oncol. 2008;19(6):1146–53.

    Article  PubMed  CAS  Google Scholar 

  13. Romano F, Garancini M, Uggeri F, Degrate L, Nespoli L, Gianotti L, et al. Surgical treatment of liver metastases of gastric cancer: state of the art. World J Surg Oncol. 2012;10(157):157.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Takemura N, Saiura A, Koga R, Arita J, Yoshioka R, Ono Y, et al. Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections. Langenbecks Arch Surg. 2012;397(6):951–7. doi:10.1007/s00423-012-0959-z.

    Article  PubMed  Google Scholar 

  15. Wang YN, Shen KT, Ling JQ, Gao XD, Hou YY, Wang XF, et al. Prognostic analysis of combined curative resection of the stomach and liver lesions in 30 gastric cancer patients with synchronous liver metastases. BMC Surg. 2012;12(20):20.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Qiu JL, Deng MG, Li W, Zou RH, Li BK, Zheng Y, et al. Hepatic resection for synchronous hepatic metastasis from gastric cancer. Eur J Surg Oncol. 2013;39(7):694–700.

    Article  PubMed  Google Scholar 

  17. Takemura N, Saiura A, Koga R, Sano T, Yamaguchi T. Surgical indication and survival benefit of hepatectomy for gastric cancer liver metastasis. Gan To Kagaku Ryoho. 2012;39(13):2455–9.

    PubMed  Google Scholar 

  18. Chen L, Song MQ, Lin HZ, Hao LH, Jiang XJ, Li ZY, et al. Chemotherapy and resection for gastric cancer with synchronous liver metastases. World J Gastroenterol. 2013;19(13):2097–103. doi:10.3748/wjg.v19.i13.2097.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  19. Jagric T, Potrc S. Prediction of liver metastases after gastric cancer resection with the use of learning vector quantization neural networks. Dig Dis Sci. 2010;55(11):3252–61.

    Article  PubMed  Google Scholar 

  20. Dittmar Y, Altendorf-Hofmann A, Rauchfuss F, Gotz M, Scheuerlein H, Jandt K, et al. Resection of liver metastases is beneficial in patients with gastric cancer: report on 15 cases and review of literature. Gastric Cancer. 2012;15(2):131–6.

    Article  PubMed  Google Scholar 

  21. Garancini M, Uggeri F, Degrate L, Nespoli L, Gianotti L, Nespoli A, et al. Surgical treatment of liver metastases of gastric cancer: is local treatment in a systemic disease worthwhile? HPB (Oxf). 2012;14(3):209–15.

    Article  Google Scholar 

  22. Sun J, Song Y, Wang Z, Chen X, Gao P, Xu Y, et al. Clinical significance of palliative gastrectomy on the survival of patients with incurable advanced gastric cancer: a systematic review and meta-analysis. BMC Cancer. 2013;13(577):577.

    Article  PubMed  CAS  Google Scholar 

  23. Koga R, Yamamoto J, Ohyama S, Saiura A, Seki M, Seto Y, et al. Liver resection for metastatic gastric cancer: experience with 42 patients including eight long-term survivors. Jpn J Clin Oncol. 2007;37(11):836–42.

    Article  PubMed  Google Scholar 

  24. Sakamoto Y, Sano T, Shimada K, Esaki M, Saka M, Fukagawa T, et al. Favorable indications for hepatectomy in patients with liver metastasis from gastric cancer. J Surg Oncol. 2007;95(7):534–9.

    Article  PubMed  Google Scholar 

  25. Ueda K, Iwahashi M, Nakamori M, Nakamura M, Naka T, Ishida K, et al. Analysis of the prognostic factors and evaluation of surgical treatment for synchronous liver metastases from gastric cancer. Langenbecks Arch Surg. 2009;394(4):647–53.

    Article  PubMed  Google Scholar 

  26. Kokudo N, Tada K, Seki M, Ohta H, Azekura K, Ueno M, et al. Anatomical major resection versus nonanatomical limited resection for liver metastases from colorectal carcinoma. Am J Surg. 2001;181(2):153–9.

    Article  PubMed  CAS  Google Scholar 

  27. Kumagai K, Shimizu K, Yokoyama N, Aida S, Tanaka T, Yamagata K. Gastrointestinal cancer metastasis and lymphatic advancement. Surg Today. 2010;40(4):301–6.

    Article  PubMed  Google Scholar 

  28. Hwang SE, Yang DH, Kim CY. Prognostic factors for survival in patients with hepatic recurrence after curative resection of gastric cancer. World J Surg. 2009;33(7):1468–72.

    Article  PubMed  Google Scholar 

  29. Tan MC, Butte JM, Gonen M, Kemeny N, Fong Y, Allen PJ, et al. Prognostic significance of early recurrence: a conditional survival analysis in patients with resected colorectal liver metastasis. HPB (Oxf). 2013;15(10):803–13.

    Article  Google Scholar 

  30. Liu J, Li JH, Zhai RJ, Wei B, Shao MZ, Chen L. Predictive factors improving survival after gastric and hepatic surgical treatment in gastric cancer patients with synchronous liver metastases. Chin Med J (Engl). 2012;125(2):165–71.

    Google Scholar 

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Acknowledgments

This work was supported by the National Natural Science Funds of China (Grant No. 81401952).

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Correspondence to Rupeng Zhang.

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Wang, W., Liang, H., Zhang, H. et al. Prognostic significance of radical surgical treatment for gastric cancer patients with synchronous liver metastases. Med Oncol 31, 258 (2014). https://doi.org/10.1007/s12032-014-0258-3

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  • DOI: https://doi.org/10.1007/s12032-014-0258-3

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