[Surgical indication and survival benefit of hepatectomy for gastric cancer liver metastasis].

Liver resection is now widely accepted as a potentially curative treatment for colorectal liver metastasis. However, the efficacy of surgical resection for gastric cancer liver metastasis(GLM)remains unclear. Based on our 18-year experience with 64 patients who underwent curative hepatectomy for GLM, we discuss the indication and efficacy of surgical resection for GLM. From January 1993 to January 2011, 73 patients underwent hepatectomy for GLM in the Department of Gastroenterological Surgery, Cancer Institute Ariake Hospital(Japanese Foundation for Cancer Research), Japan. The actuarial1 -, 3-, and 5-year overall survival rates and 1-, 3-, and 5-year recurrence-free survival rates of those 64 patients who achieved curative resections were 84, 50, and 37%, and 42, 27, and 27%, respectively. By multivariate analysis, serosal invasion of the primary gastric cancer and larger hepatic tumor(>5 cm in diameter)were found to be independent indicators of poor prognosis. Based on the multivariate analysis results, all patients were divided into three groups no poor prognostic factor(n=38), one poor prognostic factor(n=24), and two poor prognostic factors(n=2). The actuarial overall survival rates of each group were 63, 36, and 0% at 3 years, and 53, 15, and 0% at 5 years. GLM patients having hepatic tumors with the maximum diameter of <5 cm, and without serosalinvasion of the primary gastric cancer, are the best candidates for hepatectomy.