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TREATMENT OF GASTRIC LIVER METASTASES:SECOND UPDATING
MARCH 2003
Sakamoto et al found 5% of the 4730 patients who underwent gastrectomy for gastric cancer at their institution between 1985 and 2001 developed liver metastases develop synchronously or metachronously, but only 10% of them underwent hepatic resection. This small population of patients is discussed in their study.
Surgical resection for liver metastases of gastric cancer may be beneficial for patients with a
solitary metastasis, whether it is synchronous or metachronous.On the contrary Ambiru et al reported significantly longer survival in patients with metachronous metastasis (5-year survival, 29%) than in those with synchronous disease (5-year survival, 6%), and other authors have also reported favorable outcomes in patients with metachronous metastasis.
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Regional lymph node metastasis is well established as the most important prognostic factor in patients with gastric cancer. Despite curative resection of their primary tumor, some patients with histologically node-negative gastric cancer will die as a result of local or distant tumor recurrence. Therefore, additional markers would be helpful for predicting patients at risk for recurrence.It is controversial whether lymph node micrometastasis detected by immunohistochemistry predicts the clinical outcome of patients with histologically node-negative gastric cancer.
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The intraoperative diagnosis of lymph node micrometastasis (LNM) may help guide the area of appropriate lymph node dissection. Matsumoto et al aimed to evaluate the rapid immunohistochemical detection of LNMs using frozen sections during operation for gastro-oesophageal cancer. Intraoperative rapid immunostaining is a simple and useful technique for detecting LNMs. Further study should investigate the role of rapid immunostaining during cancer surgery to select appropriate areas for lymphadenectomy.
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Past Articles
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