Do liver metastases from gastric cancer contraindicate aggressive surgical resection? A 14-year single-center experience

Figure 1 Therapeutic strategy for liver metastases originated from gastric cancer. Japanese classification of gastric carcinoma: definitions of PD and PR. LMGC: Liver metastases originated from gastric cancer; LR: Liver response; NAC: Neoadjuvant chemotherapy; PR: Partial response; PD: Progressive disease.

Figure 2 Actual treatments for synchronous and metachronous liver metastases originated from gastric cancer. Seventeen patients had metachronous liver metastases originated from gastric cancer (LMGC) and 13 patients had synchronous LMGC. Seven patients with metachronous LMGC underwent liver resection (LR), and two of these seven patients subsequently received adjuvant chemotherapy. Four patients with metachronous LMGC received chemotherapy, and LR was subsequently performed. A partial response to neoadjuvant chemotherapy was achieve in two patients. Four of these 10 patients received adjuvant chemotherapy. Ten patients with synchronous LMGC underwent LR, and 9 of these 10 patients subsequently received adjuvant chemotherapy. Three patients with synchronous LMGC received chemotherapy, and LR was subsequently performed. All responses to neoadjuvant chemotherapy were categorized as partial responses. ¹One case of conversion was involved. LMGC: Liver metastases originated from gastric cancer; LR: Liver resection.

Figure 3 Overall survival and recurrence-free survival after initial liver resection. A and B: Actual curves of overall survival and recurrence-free survival. LR: Liver resection; OS: Overall survival; RFS: Recurrence-free survival.

Figure 4 Survival curves in patients with recurrence. Recurrence after the initial liver resection was observed in 21 patients. Additional surgeries were performed in nine patients with recurrence, and each additional surgery accomplished graphical and surgical R0. These 9 patients had significantly longer survival than the other 12 patients who did not undergo additional surgeries (P < 0.05). LR: Liver resection; OS: Overall survival.