Strategies For Liver Metastases From Gastric Cancer

Aim:This study evaluated the efficacy of chemotherapy and liver radiofrequency ablation (RFA) for the treatment of liver metastases from gastric cancer (LMGC), and discussed the strategies.Materials and Methods:We enrolled a total of101LMGC inpatients (87male and14female; age range24-93years) in the second affiliated hospital of Zhejiang University, School of Medicine, from January2008to December2013. Among these patients, there were65cases underwent chemotherapy,20cases underwent RFA during the treatment, and16cases as the control. The primary endpoint of this study was overall survival (OS).Results:The overall mean survival of chemotherapy group since the first diagnosis was14.4months (95%CI:11.7-17.0months), while the one of control group was4.2months (95%CI:2.2-6.2months)(P<0.05). The overall mean survival since the first RFA was16.7months (95%CI:4.8-30.6months). In RFA group, the mean survival of younger than60-year group was22.5months (95%CI:15.1-29.9months), while the one of60-year or older group was11.3months (95CI:7.0-15.7months). The mean survival of extrahepatic organs metastases group was6.1months (95%CI:2.4-9.8months); while the one of no extrahepatic organs metastases group was18.7months (95%CI:12.7-24.6months). The mean recurrence time after the first RFA was3.3±3.0months. The mean recurrence time of synchronous liver metastases was3.9±3.6months, while the one of metachronous liver metastases was2.2±0.7months (P=0.048). The mean recurrence time of solitary liver metastases was4.8±4.4months, while the one of multiple liver metastases was2.5±1.5months (P=0.031).Conclusion:Chmotherapy can prolong the survival period of LMGC patients. RFA is a minimally invasive treatment with low risk and extremely low severe complications. It can prolong survival period of LMGC patients who are younger than60-year and without extrahepatic metastases, age is an independent factor. Metachronous and multiple liver metastases recur in relatively shorter time. The clinical efficacy of chemotherapy and RFA is limited, and multidisciplinary treatment might be promising in the future.