TY - JOUR
T1 - Response to Preoperative Chemotherapy Predicts Survival in Patients Undergoing Hepatectomy for Liver Metastases from Gastric and Esophageal Cancer
AU - Andreou, Andreas
AU - Viganò, Luca
AU - Zimmitti, Giuseppe
AU - Seehofer, Daniel
AU - Dreyer, Martin
AU - Pascher, Andreas
AU - Bahra, Marcus
AU - Schoening, Wenzel
AU - Schmitz, Volker
AU - Thuss-Patience, Peter C.
AU - Denecke, Timm
AU - Puhl, Gero
AU - Vauthey, Jean Nicolas
AU - Neuhaus, Peter
AU - Capussotti, Lorenzo
AU - Pratschke, Johann
AU - Schmidt, Sven Christian
PY - 2014
Y1 - 2014
N2 - Background: The role of hepatectomy for patients with liver metastases from gastric and esophageal cancer (GELM) is not well defined. The present study examined the morbidity, mortality, and long-term survivals after liver resection for GELM.Methods: Clinicopathological data of patients who underwent hepatectomy for GELM between 1995 and 2012 at two European high-volume hepatobiliary centers were assessed, and predictors of overall survival (OS) were identified. In addition, the impact of preoperative chemotherapy for GELM on OS was evaluated.Results: Forty-seven patients underwent hepatectomy for GELM. The primary tumor was located in the stomach, cardia, and distal esophagus in 27, 16, and 4 cases, respectively. Twenty patients received preoperative chemotherapy before hepatectomy. After a median follow-up time of 76 months, 1-, 3-, and 5-year OS rates were 70, 37, and 24 %, respectively. Postoperative morbidity and mortality rates were 32 and 4 %, respectively. Outcomes were comparable between the two centers. Preoperative chemotherapy for GELM (5-year OS: 45 vs 9 %, P =.005) and the lack of posthepatectomy complications (5-year OS: 34 vs 0 %, P Conclusion: For selected patients with GELM, liver resection is safe and should be regarded as a potentially curative approach. A multimodal treatment strategy including systemic therapy may provide better patient selection resulting in prolonged survival in patients with GELM undergoing hepatectomy.
AB - Background: The role of hepatectomy for patients with liver metastases from gastric and esophageal cancer (GELM) is not well defined. The present study examined the morbidity, mortality, and long-term survivals after liver resection for GELM.Methods: Clinicopathological data of patients who underwent hepatectomy for GELM between 1995 and 2012 at two European high-volume hepatobiliary centers were assessed, and predictors of overall survival (OS) were identified. In addition, the impact of preoperative chemotherapy for GELM on OS was evaluated.Results: Forty-seven patients underwent hepatectomy for GELM. The primary tumor was located in the stomach, cardia, and distal esophagus in 27, 16, and 4 cases, respectively. Twenty patients received preoperative chemotherapy before hepatectomy. After a median follow-up time of 76 months, 1-, 3-, and 5-year OS rates were 70, 37, and 24 %, respectively. Postoperative morbidity and mortality rates were 32 and 4 %, respectively. Outcomes were comparable between the two centers. Preoperative chemotherapy for GELM (5-year OS: 45 vs 9 %, P =.005) and the lack of posthepatectomy complications (5-year OS: 34 vs 0 %, P Conclusion: For selected patients with GELM, liver resection is safe and should be regarded as a potentially curative approach. A multimodal treatment strategy including systemic therapy may provide better patient selection resulting in prolonged survival in patients with GELM undergoing hepatectomy.
KW - Esophageal cancer
KW - Gastric cancer
KW - Liver metastases
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U2 - 10.1007/s11605-014-2623-0
DO - 10.1007/s11605-014-2623-0
M3 - Article
C2 - 25159501
AN - SCOPUS:84920875162
VL - 18
SP - 1974
EP - 1986
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
SN - 1091-255X
IS - 11
ER -