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Is there a role for treatment-oriented surgery in liver metastases from gastric cancer? | LitMetric

AI Article Synopsis

  • About 35% of patients with gastric cancer have distant metastases at diagnosis, with a small percentage eligible for radical surgery, particularly those with liver involvement.
  • The study systematically reviewed literature from 2000 to 2018, analyzing factors that impact survival in patients with liver metastatic gastric cancer, involving 2304 patients across 47 studies.
  • Results showed variable median survival rates and overall survival at 1 to 5 years, highlighting that certain factors like serous infiltration and lymph node involvement predict worse outcomes, while limited metastases may allow for surgical options.

Article Abstract

Background: Distant metastases are found in approximately 35% of patients with gastric cancer at their first clinical observation, and of these, 4%-14% involves the liver. Unfortunately, only 0.4%-2.3% of patients with metastatic gastric cancer are eligible for radical surgery. Although surgical resection for gastric cancer metastases is still debated, there have been changes in recent years, although several clinical issues remain to be defined and that must be taken into account before surgery is proposed.

Aim: To analyze the clinicopathological factors related to primary gastric tumor and metastases that impact the survival of patients with liver metastatic gastric cancer.

Methods: We performed a systematic review of the literature from 2000 to 2018 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The study protocol was based on identifying studies with clearly defined purpose, eligibility criteria, methodological analysis, and patient outcome.

Results: We selected 47 studies pertaining to the purpose of the review, which involved a total of 2304 patients. Median survival was 7-52.3 mo, median disease-free survival was 4.7-18 mo. The 1-, 2-, 3-, and 5-year overall survival (OS) was 33%-90.1%, 10%-60%, 6%-70.4%, and 0%-40.1%, respectively. Only five papers reported the 10-year OS, which was 5.5%-31.5%. The general recurrence rate was between 55.5% and 96%, and that for hepatic recurrence was between 15% and 94%.

Conclusion: Serous infiltration and lymph node involvement of the primary cancer indicate an unfavorable prognosis, while the presence of single metastasis or ≤ 3 metastases associated with a size of < 5 cm may be considered data that do not contraindicate liver resection.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407929PMC
http://dx.doi.org/10.5306/wjco.v11.i7.477DOI Listing

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