SURGICAL-TREATMENT FOR GASTRIC CARCINOMAS WITH CONCOMITANT HEPATIC METASTASIS

Background/Aims: We have reviewed our experience with gastric cancer p atients having synchronous liver metastasis in an attempt to clarify h ow to treat such patients. Patients and Methods: In 116 patients with gastric cancer metastatic to the liver, evaluations were executed to f ind an effective treatment. Fourteen received gastrectomy plus hepatic resection (Group A), 68 gastrectomy alone (Group B), and 34 non-resec ted (Group C). Results: The average survival time was 15.0 months in G roup A, 7.2 months in Group B and 3.6 months in Group C, with statisti cal difference between Group B and Group C (p<0.05). In Group A patien ts, the mean survival time was 21.5 months in those undergoing potenti ally curative surgery for the carcinoma without incurable factors othe r than liver metastasis. The survival time was 6.3 months in those und ergoing noncurative gastrectomy and hepatectomy because of evidence of incurable metastatic spread, the value being similar to that followin g gastrectomy alone in Group B patients. In Group B, adjuvant chemothe rapy led to a significant increase in survival (p<0.05). Conclusions: Hepatectomy combined with gastrectomy seems to be effective as an acti ve measure to lengthen survival for patients of gastric carcinoma and concomitant liver metastasis only when other incurable factors were no t evident at operation. Noncurative gastrectomy followed by adjuvant c hemotherapy is recommended in the presence of various incurable factor s.