Gastric cancer with liver metastasis (GCLM) is the leading cause of death in patients with advanced gastric cancer. Multiple metastasis was common in GCLM and usually complicated with lesions outside the liver, especially peritoneal metastasis. Most of liver metastasis lesions could not be resected radically. Currently, main treatments for GCLM included radical operation, palliative resection of gastric cancer, ablation of metastatic lesions, intervention and systemic chemotherapy. Based on the current progress in the treatment for GCLM and our clinical experience, the general status of patients, the type of gastric cancer and the degree of liver metastasis should be analyzed, and a cooperative multidisciplinary team (MDT) should be applied to conduct and to choose active and suitable comprehensive treatment for GCLM patients based on individualized therapy principle.
Humans ; Liver Neoplasms ; secondary ; therapy ; Stomach Neoplasms ; pathology ; therapy

Humans ; Liver Neoplasms ; secondary ; surgery ; Stomach Neoplasms ; pathology ; surgery

A 65-year-old male patient presented multiple cutaneous nodules on trunk and an erythematous inflammatory lesion resembling erysipelas on left side of neck. Result of skin biopsies disclosed groups of metastatic adenocarcinoma cells in the dermis, subcutaneous tissue, and lumina of the lymphatic vessels. Histopathologic examination of the stomach, along with the gastroscope, established that the cutaneous metastasis was of stomach origin.
Adenocarcinoma/pathology/*secondary ; Aged ; Humans ; Male ; Skin Neoplasms/pathology/*secondary ; Stomach Neoplasms/*pathology

Blood-borne metastatic involvement of the stomach by cancer is a rare entity. According to the number of reports in the literature, the most common tumors that spread to the stomach through the blood stream are malignant melanoma, breast carcinoma and lung carcinoma. Recently, two cases of metastatic involvement of the stomach secondary to lung carcinoma were diagnosed by gastroscopy. The first patient was a 66-year-old man who had primary lung carcinoma with multiple bone and subcutaneous metastases. Gastroscopy showed multiple submucosal tumors with central umbilications in the fundus and in the upper body of the stomach. Pathologic examination revealed massive submucosal infiltration and conical shaped and scanty deep mucosal infiltration of undifferentiated small cell carcinoma suggestive of metastatic involvement. The second patient was a 68-year-old man who had primary lung carcinoma with brain metastasis. Gastroscopy showed a large fungating mass in the greater curvature side of the stomach. Pathologic examination revealed poorly differentiated squamous cell carcinoma. We report the two cases of metastatic gastric cancer from lung carcinoma with the literature review.
Aged ; Carcinoma, Small Cell/*secondary ; Carcinoma, Squamous Cell/*secondary ; Humans ; Lung Neoplasms/*pathology ; Male ; Stomach Neoplasms/*secondary

Adenocarcinoma ; pathology ; secondary ; surgery ; Adult ; Bone Marrow Neoplasms ; diagnosis ; secondary ; Female ; Humans ; Postoperative Period ; Stomach Neoplasms ; pathology ; surgery

Gastric metastasis of lung carcinoma is a rare entity which is detected mostly at autopsy. Patients diagnosed as having those on lifetime are extremely rare. In addition to our case, 54 cases of lung carcinoma metastasis to the gastro-intestinal tract have been reported in the literature since 1961. We report a case of gastric metastasis originated from small cell lung carcinoma. The patient was a 87-year-old man. He refused lung biopsy and further treatment and died 2 months after the diagnosis. This is the case of gastric metastsis originated from lung carcinoma, which was confirmed by immunohistochemical staining.
Aged ; Aged, 80 and over ; Carcinoma, Small Cell/diagnosis/*secondary ; English Abstract ; Humans ; Lung Neoplasms/*pathology ; Male ; Stomach Neoplasms/diagnosis/*secondary

OBJECTIVEThis review discusses the current status and progress in studies on gastric cancer with liver metastasis (GCLM), involving the routes, subtypes, and prognosis of GCLM; the genes and molecules associated with metastasis; the feasibility and value of each imaging modality; and current treatment options.

DATA SOURCESThe data used in this review were mainly from Medline and PubMed published in English from 2005 to August 2010. The search terms were "gastric cancer" and "liver metastasis".

STUDY SELECTIONArticles regarding the characteristics, diagnostic modalities, and various therapeutic options of GCLM were selected.

RESULTSThe prognosis of GCLM is influenced by the clinicopathological characteristics of primary tumors, as well as the presence of liver metastases. Improved understanding of related genes and molecules will lead to the development of methods of early detection and targeted therapies. For the diagnosis of GCLM, each imaging modality has its relative benefits. There remains no consensus regarding therapeutic options.

CONCLUSIONSEarly detection and characterization of liver metastases is crucial for the prognosis of gastric cancer patients. Multidisciplinary team discussions are required to design optimal treatment strategies, which should be based on the clinicopathological characteristics of each patient.

Humans ; Liver Neoplasms ; diagnosis ; drug therapy ; secondary ; surgery ; Stomach Neoplasms ; complications ; diagnosis ; drug therapy ; surgery

Hepatoid adenocarcinoma of the stomach (HAS) is a special type of gastric cancer characterized with hepatoid differentiation and the production of large amounts of α-fetoprotein (AFP). The pathogenesis of HAS is still not clear. Most of the relative studies are single case reports, and studies with large sample are absent. The prognosis of HAS is poor. HAS has a high rate of liver metastasis. The biology behaviors of HAS differ from common gastric cancers. Radical resection of the gastric cancer is considered to be the main treatment when no liver metastasis is found, while the treatment regimens of the metastasis lesions are still in debate. The serum AFP test is important for the early detection and diagnosis of HAS, and it is crucial for monitoring the therapeutic effect and the relapse and metastasis of the tumor.
Adenocarcinoma ; Humans ; Liver Neoplasms ; secondary ; Neoplasm Recurrence, Local ; Prognosis ; Stomach Neoplasms ; pathology ; alpha-Fetoproteins

OBJECTIVETo assess the value of gastric and hepatic surgical treatment in gastric cancer patients with liver metastasis and its prognostic implication.

METHODSLiterature search was performed in pubmed, Embase, Ovid, Springer-Link, Web of Science, CNKI, CBMdisc for clinical research published before March 2013 that compared gastrectomy alone to gastrectomy and hepatectomy. Inclusion criteria and exclusion criteria were performed. Quality assessment was based on NOS scale. Stata12.0 was used for statistical analysis.

RESULTSNine studies including 431 patients were enrolled for analysis, among whom 189 underwent gastrectomy and hepatectomy and 242 underwent gastrectomy alone. Gastrectomy and hepatectomy group had better survival(HR=0.50, 95%CI:0.34-0.72, z=3.66, P=0.000). There was a subgroup analysis. Gastrectomy with hepatectomy group had significant advantages in prognosis in four foreign studies(HR=0.28, 95%CI:0.18-0.44, z=5.77, P=0.000). There was no significant difference in five domestic studies (HR=0.74, 95%CI:0.55-1.00, z=1.95, P=0.051).

CONCLUSIONGastrectomy and hepatectomy in gastric cancer patients with liver metastasis improves long-term survival in select patients.

Gastrectomy ; Hepatectomy ; Humans ; Liver Neoplasms ; secondary ; surgery ; Prognosis ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo explore the clinicopathological characteristics and related risk factors in metachronous liver metastasis of gastric cancer.

METHODSClinical data of 115 patients with metachronous liver metastasis in Tianjin Medical University Cancer Institute and Hospital between 1996 and 2008 were analyzed retrospectively.

RESULTSAmong 115 patients, the 1-, 3- and 5-year non-hepatic metastasis rates were 45.3%, 14.8% and 3.5% respectively. Univariate Log-rank test indicated that location, tumor size, tumor differentiation, depth of invasion, lymph node metastasis, vascular invasion, nervous invasion, soft tissue invasion, and modes of gastrectomy were significant factors associated with hepatic metastasis after radical gastrectomy. On multivariate analysis, the size of gastric cancer, vascular invasion, tumor differentiation, and lymph node metastasis were independent factors associated with metachronous liver metastasis of gastric cancer.

CONCLUSIONSThe size of gastric cancer, vascular invasion, tumor differentiation and lymph node metastasis are important factors associated with the risk of hepatic metastasis from gastric cancer in patients after radical gastrectomy.

Gastrectomy ; Humans ; Liver Neoplasms ; secondary ; therapy ; Lymphatic Metastasis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; pathology ; therapy