Aggressive surgery for liver metastases from gastrointestinal stromal tumors.

Background/purpose: The utility of hepatectomy for patients with metastatic liver tumors from gastrointestinal stromal tumors (GISTs) was evaluated in the present study.

Methods: Between 1989 and 2001, ten patients with liver metastases from GIST (four men and six women; age, 34-77 years) underwent hepatectomy at our hospital. All patients underwent complete resection of the primary tumor and hepatectomy with or without microwave coagulation therapy (MCT) for all detectable hepatic tumors.

Results: The median survival time after hepatectomy was 39 months (range, 1 to 96 months). There was one postoperative death. One patient is still alive with relapse of hepatic tumors, and the remaining eight patients died of disease (liver in six, peritoneum in one, and bone in one). Relapse of hepatic tumors occurred in seven patients. The disease-free rate after hepatectomy was 22% at 2 years and 11% at 5 years. The survival times of the four patients who received hepatic arterial chemoembolization for recurrent hepatic metastases were 7 months (still alive), 17, 23, and 28 months (average, 19 months).

Conclusions: Our data suggest that aggressive surgery (hepatectomy and MCT) for all detectable hepatic tumors and hepatic arterial chemoembolization for recurrent hepatic metastases improve survival.