Resection of liver metastasis from gastric adenocarcinoma

Citation
K. Fujii et al., Resection of liver metastasis from gastric adenocarcinoma, HEP-GASTRO, 48(38), 2001, pp. 368-371
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology","da verificare
Journal title
HEPATO-GASTROENTEROLOGY
ISSN journal
0172-6390 → ACNP
Volume
48
Issue
38
Year of publication
2001
Pages
368 - 371
Database
ISI
SICI code
0172-6390(200103/04)48:38<368:ROLMFG>2.0.ZU;2-V
Abstract
Background/Aims: To determine the factors influencing the prognosis of pati ents undergoing resection of liver metastases from gastric adenocarcinoma. Methodology: Over a 10-year period, at Kiryu Kousei General Hospital, 12 pa tients underwent potentially curative hepatectomy for metastatic adenocarci noma of gastric origin. Two patients were excluded from this study, one bec ause of postoperative death and one due to insufficient follow-up. We retro spectively examined the following factors: including TNM classification of the primary tumor, disease-free interval between gastric and hepatic resect ion, number and maximum diameter of the metastases, histological differenti ation of the metastases, and the presence of lymphocyte aggregation enclosi ng the metastatic lesions. Survival rates were estimated by the Kaplan-Meie r method and the weighting of each factor was compared by the log-rank test . Results: The overall 5-year survival rate of the 10 patients was 10%. The m edian survival time after hepatectomy was 16.3 months, ranging from 3.1 to 245.7 months. Eight patients died of recurrent cancer and 1 died of unrelat ed septic shock with no evidence of cancer recurrence. Only one patient was alive without recurrence at the time of maximum follow-up. A significant s urvival advantage was noted in patients with disease-free interval greater than or equal to1 year, and those with metastatic tumors < 5cm in maximum d iameter and/or enclosed by the aggregated lymphocytes, when compared with p atients with disease-free interval <1 year and those with metastatic tumors greater than or equal to 5cm and/or directly infiltrated hepatic parenchym a. Conclusions: It was suggested that hepatectomy should be attempted in patie nts where the disease-free interval was greater than or equal to1 year and with metastatic nodules <5cm. Lymphocyte aggregation around the metastatic tumor is a good prognostic sign for longterm survival.