Comparison of clinical efficacy of different treatment methods for synchronous liver metastasis from gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of different treatments for synchronous liver metastasis from gastric cancer.</p><p><b>METHODS</b>Clinicopathological and follow-up data of 271 patients with synchronous liver metastasis from gastric cancer between January 1998 and November 2012 were analyzed retrospectively. Among 271 patients, 34 received surgery alone, 95 received chemotherapy alone, and 120 received combined therapy. The prognosis was compared.</p><p><b>RESULTS</b>The median survival time was 8 months (3-41 months) in the surgery group and the cumulative 1-, 3- and 5-year survival rates were 32.4%, 2.9% and 0. The median survival time was 7 months (3-50 months) in the chemotherapy group and the cumulative 1-, 3- and 5-year survival rates were 21.1%, 1.1% and 0 respectively. The median survival time was 11 months (3-84 months) in the combined group and the cumulative 1-, 3- and 5-year survival rates were 50.0%, 5.0% and 0.8% respectively. The differences among groups were all statistically significant (all P<0.05). Extent of lymph node metastasis, therapeutic strategies, and liver metastasis management were significantly independent prognostic factors for synchronous liver metastasis from gastric cancer.</p><p><b>CONCLUSIONS</b>Comprehensive treatment based on operation may improve the long-term survival of patients with synchronous liver metastasis from gastric cancer.</p>

Meta-analysis of prognosis after surgical treatment in gastric cancer patients with liver metastasis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the value of gastric and hepatic surgical treatment in gastric cancer patients with liver metastasis and its prognostic implication.</p><p><b>METHODS</b>Literature search was performed in pubmed, Embase, Ovid, Springer-Link, Web of Science, CNKI, CBMdisc for clinical research published before March 2013 that compared gastrectomy alone to gastrectomy and hepatectomy. Inclusion criteria and exclusion criteria were performed. Quality assessment was based on NOS scale. Stata12.0 was used for statistical analysis.</p><p><b>RESULTS</b>Nine studies including 431 patients were enrolled for analysis, among whom 189 underwent gastrectomy and hepatectomy and 242 underwent gastrectomy alone. Gastrectomy and hepatectomy group had better survival(HR=0.50, 95%CI:0.34-0.72, z=3.66, P=0.000). There was a subgroup analysis. Gastrectomy with hepatectomy group had significant advantages in prognosis in four foreign studies(HR=0.28, 95%CI:0.18-0.44, z=5.77, P=0.000). There was no significant difference in five domestic studies (HR=0.74, 95%CI:0.55-1.00, z=1.95, P=0.051).</p><p><b>CONCLUSION</b>Gastrectomy and hepatectomy in gastric cancer patients with liver metastasis improves long-term survival in select patients.</p>