Hepatic Resection in Patients with Liver Metastasis from Gastric Cancer.
10.5230/jkgca.2009.9.1.14
- Author:
Kyong Hwa JUN
1
;
Hyung Min CHIN
Author Information
1. Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea. hchin@catholic.ac.kr
- Publication Type:Review
- Keywords:
Gastric cancer;
Liver metastasis;
Hepatic resection
- MeSH:
Chemotherapy, Adjuvant;
Follow-Up Studies;
Gastric Stump;
Humans;
Liver;
Lymph Nodes;
Neoplasm Metastasis;
Pancreas;
Recurrence;
Stomach Neoplasms;
Survivors
- From:Journal of the Korean Gastric Cancer Association
2009;9(1):14-17
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The clinical significance of hepatic resection for gastric metastases is controversial, even though hepatic resection has been widely accepted as a modality for colorectal metastases. Very few patients with gastric hepatic metastases are good candidates for hepatic resection because of multiple bilateral metastases, extrahepatic disease, or advanced cancer progression, such as peritoneal dissemination or extensive lymph node metastases. Therefore, several authors have reported the clinical significance of hepatic resection for gastric metastases in a small number of patients. Considering the present results with previous reports. The number and distribution of tumors in hepatic metastases from gastric cancer was considered based on the present and previous reports. Several authors have reported significantly better survival in patients with metachronous metastasis than in those with synchronous disease. However, metachronous hepatic resection necessitates the dissection of adhesions between the pancreas, liver, and residual stomach to prepare for Pringle's maneuver. Patients with unilobar liver metastasis, and/or metastatic tumors <4 cm in diameter may be good candidates for hepatic resection. Synchronous metastasis is not a contraindication for hepatic resection. Most of the long-term survivors underwent anatomic hepatic resection with a sufficient resection margin. After hepatic resection, the most frequent site of recurrence was the remaining liver, which was associated with a high frequency of mortality within 2 years. A reasonable strategy for improvement in survival would be to prevent recurrence by means of adjuvant chemotherapy and careful follow-up studies.
