Surgical Management of Liver Metastases from Gastric Cancer
Summary
Liver metastases occur in a significant minority of patients with gastric cancer and are associated with poor prognosis. Historically managed with palliative chemotherapy alone, selected patients with limited hepatic disease have shown improved outcomes following surgical intervention. The principal surgical modalities include hepatectomy—ranging from wedge resection to anatomical lobectomy—and percutaneous radiofrequency ablation in cases unsuitable for resection. Patient selection hinges on factors such as number and distribution of liver lesions, absence of extrahepatic disease, response to systemic therapy and performance status. Multimodal treatment, combining perioperative chemotherapy with surgery, has emerged as a strategy to downstage disease, eradicate micrometastases and prolong survival. In the synchronous setting, immediate resection may be feasible if lesions are solitary and resectable; in metachronous presentations, delayed hepatectomy or ablation following systemic control is often applied. Long-term survivors underscore the potential of aggressive local therapy in a carefully selected subset of patients, leading to a shift in guidelines toward offering surgical management within multidisciplinary programmes.
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Surgical Management of Liver Metastases from Gastric Cancer publication trend
The graph below shows the total number of articles in surgical management of liver metastases from gastric cancer across all publications each year (not limited to Nature Index journals).
Technical terms
Oligometastasis: A limited metastatic state characterised by a small number of lesions confined to a single organ, potentially curable by local therapies.
Hepatectomy: Surgical removal of part or all of the liver, often used to excise metastatic deposits.
Radiofrequency ablation (RFA): A minimally invasive technique that uses thermal energy to destroy tumour tissue.
Autophagy flux: The dynamic process by which cells degrade and recycle intracellular components through autophagosomes and lysosomes.
Tumour-associated macrophages (TAMs): Immune cells within the tumour microenvironment that can promote cancer cell survival, invasion and resistance to therapy.
References
- Tumor-associated macrophage-derived GDNF promotes gastric cancer liver metastasis via a GFRA1-modulated autophagy flux. Cellular Oncology (2023).
- Oligometastasis of Gastric Cancer: A Review. Cancers (2024).
- The GYMSSA trial: a prospective randomized trial comparing gastrectomy, metastasectomy plus systemic therapy versus systemic therapy alone. Trials (2009).
- Combination of percutaneous radiofrequency ablation and systemic chemotherapy are effective treatment modalities for metachronous liver metastases from gastric cancer. Clinical & Experimental Metastasis (2013).
- Outcomes of surgical resection for gastric cancer liver metastases: a retrospective analysis. World Journal of Surgical Oncology (2020).
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