Analysis of hepatic resection of metastasis originating from gastric adenocarcinoma |
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Authors: | Johannes Zacherl MD Maximilian Zacherl MD Christian Scheuba MD Rudolf Steininger MD Etienne Wenzl MD FRCS Ferdinand Mühlbacher MD Raimund Jakesz MD Friedrich Längle MD |
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Institution: | 1. Departments of Allgemeinchirurgie, Universitätsklinik für Chirurgie and Universität Wien, Vienna, Austria;2. Transplantation, Universitätsklinik für Chirurgie and Universität Wien, Vienna, Austria |
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Abstract: | Few patients with metastatic gastric cancer have disease that is amenable to curative surgery. Thus far, little is known about
liver surgery for metastases arising from gastric adenocarcinoma and prognostic factors. Of 73 patients operated on between
1980 and 1999 for noncolorectal, non-neuroendocrine hepatic metastases, 15 underwent liver resection for gastric adenocarcinoma
metastasis. Ten patients underwent synchronous hepatic resection and five underwent metachronous hepatic surgery after a median
diseasefree interval of 10 months (range 6.1 to 47.3 months). None of the patients died within the first 30 days after surgery,
and the in-hospital mortality rate was 6.7%. Among patients in the synchronous group, 26.7% experienced major complications
mainly associated with gastric surgery. Overall median survival was 8.8 months (range 4 to 51 months); two patients survived
more than 3 years. Univariate analysis reealed that the appearance of liver metastasis synchronous vs. metachronous), the
distribution of liver metastases (unilobar vs. bilobar), and the primary tumor site (proximal vs. distal) were marginally
signifiant predictive factors regarding overall survival. Because of its high morbidity, synchronous liver resecion for metastases
originating from gastric adenocarcinoma is rarely followed by survival longer than 2 years. Primary tumor localization within
the proximal third of the stomach and bilobar liver involvement appear to be predictive of poor outcome. On the other hand,
curative resection of metachronous liver metastases may allow long-term survival in selected patients. |
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Keywords: | Liver metastasis gastric cancer resection survival |
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