A Case of Two Resections for Metachronous Liver Metastases of Gastric Cancer: A Case Report and Review of the Literature

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Ishibashi Yusuke Tsujimoto Hironori, M.D., Ph.D. Yamamoto Junji, M.D., Ph.D. Ueno Hideki, M.D., Ph.D.


Background: The clinical significance of surgical resection for liver metastases of gastric cancer remains controversial. Herein, we report a case of twice resections for metachronous liver metastases of gastric cancer in combination with perioperative chemotherapy, which resulted in long-term survival.
Case Presentation: The patient was a 66-year-old man who underwent laparoscopic total gastrectomy for gastric cancer (Stage IB) in March 2012, and subsequently underwent right hemi-hepatectomy with partial resection of the vena cava and diaphragm for solitary metastases in segments 7-8 in April 2013. In September 2013, abdominal computed tomography detected a liver metastasis in segment 4. We administered systematic chemotherapy with S-1 plus cis-diamminedichloroplatinum (CDDP). Because the tumor decreased in size after five courses, and curative resection of the tumor was considered possible, hepatic resection of S4+1 was performed in June 2014. The patient has been followed for 26 months, and, after the last hepatectomy, had no evidence of recurrence.
Conclusion: We experienced a case of long-term survival after twice resections for liver metastases from gastric cancer. Surgical resection for liver metastases of gastric cancer, even repeat hepatectomy, may be an effective treatment after careful selection of the optimal candidate.

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