Evaluation of Surgical Treatment for Gastric Cancer with Liver Metastasis

Hiromi Tanemura, Shigetoyo Saji, Sengai Tanaka¹⁾, Takao Ito¹⁾, Hiroo Oshita, Daizo Fukata¹⁾, Tomohiko Furuta, Shuji Azuma, Kiichi Miya, Katsuyuki Kunieda, Hiroshi Takao, Yasuyuki Sugiyama, Akihiko Yoshida, Kuniyasu Shimokawa²⁾

Second Department of Surgery, Gifu University School of Medicine
1)Department of Surgery, Gifu Municipal Hospital
2)Department of Laboratory Medicine, Gifu University School of Medicine

During the last 12 years 1,651 gastric cancer patients received operative treatment, and in 127 of them with synchronous liver metastases the effects of gastrectomy with and without hepatectomy or postoperative chemotherapy were defermined. In the patients with liver metastasis located in one lobe (H₁) and having equivalent background factors, the survival rate for the gastrectomy+hepatectomy group (13 patients) was better than that for the gastrectomy alone group (8 patients). Three patients in the gastrectomy+hepatectomy group are still alive after more than three years, and the longest survival is over 4 years and 7 months after the operation. The results suggest that gastrectomy alone (reduction surgery) for patients with liver metastasis and numerous scattered peritoneal metastases (P₂, P₃) is not recommendable. Systemic chemotherapy or intra-arterial chemotherapy for the liver metastasis was effective in the group treated by reduction surgery, while it was ineffective in the group without gastrectomy. There was no significant difference in survival rate between the systemic chemotherapy group and the intra-arterial chemotherapy group.

Key words
gastric cancer with liver metastasis, gastrectomy with combined hepatectomy, reduction surgery for gastric cancer, postoperative adjuvant chemotherapy, intra-arterial chemotharapy

Reprint requests
Hiromi Tanemura Second Department of Surgery, Gifu University School of Medicine
40 Tsukasa-machi, Gifu, 500 JAPAN

Accepted
January 10, 1990

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