Liver-directed treatments for liver metastasis from gastric adenocarcinoma: comparison between liver resection and radiofrequency ablation.
BACKGROUND
Although various liver-directed treatment modalities, such as liver resection and radiofrequency ablation (RFA), have been applied to treat liver metastases from gastric cancer, optimal management of them remains controversial. In patients with liver metastasis from gastric cancer, we investigated the short- and long-term outcomes of liver resection and RFA and analyzed factors influencing survival.


METHODS
A total of 98 gastric cancer patients with liver metastasis and no extrahepatic disease were treated by liver resection (n = 68) or RFA (n = 30). Short- and long-term outcomes were evaluated retrospectively for each of the liver-directed treatments.


RESULTS
Severe complication rates did not differ between liver resection (18 %) and RFA (10 %) (p = 0.333). Only one treatment-related mortality occurred in the liver resection group. No statistically significant difference in survival was noted between the treatment groups. Median overall survival after liver resection was 24 months, with 3-year overall and progression-free survival rates of 40.6 % and 30.4 %, respectively. Median overall survival after RFA was 23 months, with 3-year overall and progression-free survival rates of 43.0 % and 37.4 %, respectively. Only the size of the metastases was shown to be an independent prognostic factor for gastric cancer patients with liver metastasis.


CONCLUSIONS
In select patients with liver metastasis from gastric cancer, liver resection and RFA showed satisfactory and comparable short- and long-term results. Thus, systemic chemotherapy may not be the only therapeutic option for patients with liver metastasis, and possible liver-directed treatment options for such patients should be considered on an individual basis.
['Guner|Ali|A|', 'Son|Taeil|T|', 'Cho|In|I|', 'Kwon|In Gyu|IG|', 'An|Ji Yeong|JY|', 'Kim|Hyoung-Il|HI|', 'Cheong|Jae-Ho|JH|', 'Noh|Sung Hoon|SH|', 'Hyung|Woo Jin|WJ|http://orcid.org/0000-0002-8593-9214']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D017115:Catheter Ablation D005260:Female D005500:Follow-Up Studies D006498:Hepatectomy D006801:Humans D008113:Liver Neoplasms D008207:Lymphatic Metastasis D008297:Male D008875:Middle Aged D009361:Neoplasm Invasiveness D009364:Neoplasm Recurrence, Local D009367:Neoplasm Staging D011379:Prognosis D013274:Stomach Neoplasms D015996:Survival Rate
Liver metastasis Liver resection Radiofrequency ablation Gastric cancer Prognosis