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Annals of Oncology Advance Access originally published online on February 27, 2008
Annals of Oncology 2008 19(6):1146-1153; doi:10.1093/annonc/mdn026
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

gastrointestinal tumors

Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases

S. H. Cheon1, S. Y. Rha1, H.-C. Jeung1, C.-K. Im1, S. H. Kim2, H. R. Kim1, J. B. Ahn1, J. K. Roh1, S. H. Noh3 and H. C. Chung1,*

1 Department of Internal Medicine, Cancer Metastasis Research Center, Yonsei Cancer Center, Yonsei University College of Medicine
2 Graduate School of East-West Medical Science, Kyung Hee University, Gyeonggi-do
3 Department of Surgery, Cancer Metastasis Research Center, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea

* Correspondence to: Dr H. C. Chung, Department of Internal Medicine, Cancer Metastasis Research Center, Yonsei Cancer Center, Yonsei University College of Medicine, 134, Shinchon-Dong, Seodaemoon-gu, Seoul 120-752, South Korea. Tel: +82-2-2228-8132; Fax: +82-2-393-3652; E-mail: unchung8{at}yuhs.ac

Background: The benefit of surgical resection of liver metastases from gastric cancer has not been well established. The aim of this study was to evaluate the rationale for hepatic resection in patients with hepatic metastases from gastric cancer.

Methods: Among 10 259 patients diagnosed with gastric adenocarcinoma in the Yonsei University Health System from 1995 to 2005, we reviewed the records of 58 patients with liver-only metastases from gastric cancer who underwent gastric resection regardless of hepatic surgery.

Results: The overall 1-year, 3-year, and 5-year survival rates of 41 patients who underwent hepatic resection with curative intent were 75.3%, 31.7%, and 20.8%, respectively, and three patients survived >7 years. Of the 41 patients, 22 had complete resection and 19 had palliative resection. Between the curative and palliative resections, survival rates after curative intent were not different. The number of liver metastasis (solitary or multiple) was a marginally significant prognostic factor for survival.

Conclusions: Surgery for liver metastases arising from gastric adenocarcinoma is reasonable if complete resection seems feasible after careful preoperative staging, even if complete resection is not actually achieved. Hepatic resection should be considered as an option for gastric cancer patients with hepatic metastases.

Key words: curative intent, gastric cancer, hepatic resection, liver metastases

Received for publication December 11, 2007. Revision received January 9, 2008. Accepted for publication January 9, 2008.


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