Treatment of Gastric Cancer with Liver Metastasis

Kim, Hyeong Rok; Kim, Young Jin; Kim, Dong Yi; Kim, Shin Kon

Abstract

Liver metastasis is reported about 5 to 7 percent of the time with primary gastric cancer. Advances in diagnostic tools, such as abdominal ultrasonography and abdominal CT, have made detection of liver metastases from primary gastric cancer easy. Many studies have reported on the benefit of hepatic resection for metastatic tumors from colorectal cancer. However, few reports exist on the treatment of metastatic liver tumors from primary gastric malignancy. We experienced 70 cases of gastric cancer with liver metastases among 1391 cases of gastric cancer during a 11-year period from 1986 to 1996, and we examined the relationship between the types of treatment and the mean survival time for those no cases. To that end, those patients were divided into 4 groups. Group A was comprised of 13 patients who underwent a gastrectomy with hepatic resection. Group B was comprised of 41 patients who underwent a gastrectomy with systemic chemotherapy. Group C was comprised of 3 patients who underwent a gastrectomy with chemoimmunotherapy via hepatic artery catheter. Group D was comprised of 13 patients who underwent a gastrojejunostomy only. The thirty-month survival rate of Group A was 23% and that of Group B was 13%. This difference between Groups A and B was statistically significant (p<0.05). In Group C, one patient died within 7 months, one patient died after 13 months of survival, and one patient was still living 3 months postoperatively. In Group D, no patient survived past 12 months. These results suggest that combined resection of the stomach and a part of the liver in gastric cancer patients with liver metastasis leads to longer survival time compared with other treatment methods, such as systemic chemotherapy and chemoimmunotherapy via hepatic artery cannulation.