Liver Resection for Gastric Cancer Metastases

Background/Aims: Surgical indications in patients with liver metastases from gastric cancer are debated. To analyze outcomes of surgery and the impact of neoadjuvant chemotherapy (NeoCTx). Methodology: Consecutive patients undergoing liver resection for gastric metastases between January 1997 and December 2008 were analyzed. Results: Liver metastases were synchronous in 9 patients and multiple in 5. Eight patients received NeoCTx. NeoCTx and non-NeoCTx groups had similar characteristics. Mortality was nil, morbidity was 40%. After a mean follow-up of 42.5 months, 5-year survival rate was 33.2%. Presence of multiple metastases was a negative prognostic factor (p=0.029), while synchronous presentation and NeoCTX were not. Disease-free survival rates were significantly different by stratifying patients according to response to chemotherapy: at 5 years 32.4% in non-NeoCTx group, 0% in disease progression (PD) while on NeoCTx group and 60.0% in non-PD while on NeoCTx group (p=0.018). One-year recurrence rates were 40%, 100% and 0%, (p=0.020). Conclusions: Liver resection for gastric metastases achieves good long-term results, especially in solitary metastases. NeoCTx helps to select candidates for surgery and, in patients without PD, is associated with improved disease-free survival.