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Clinical and Translational Oncology

, Volume 20, Issue 5, pp 658–665 | Cite as

Intensified neoadjuvant multimodal approach in synchronous liver metastases from gastric cancer: a single institutional experience

  • L. Ceniceros
  • A. Chopitea
  • F. Pardo
  • F. Rotellar
  • L. Arbea
  • J. J. Sola
  • J. C. Subtil
  • B. Sangro
  • A. Benito
  • J. L. Hernández-Lizoain
  • J. Rodríguez
Research article

Abstract

Background

Synchronous liver metastases (LM) from gastric (GC) or esophagogastric junction (EGJ) adenocarcinoma are a rare events. Several trials have evaluated the role of liver surgery in this setting, but the impact of preoperative therapy remains undetermined.

Methods

Patients with synchronous LM from GC/EGJ adenocarcinoma who achieved disease control after induction chemotherapy (ICT) and were subsequently scheduled to chemoradiotherapy (CRT) to the primary tumor and surgery assessment were retrospectively analyzed. Pathological response, patterns of relapse, progression-free survival (PFS), and overall survival (OS) were calculated. From July 2002 to September 2012, 16 patients fulfilling the inclusion criteria were identified.

Results

Primary tumor site was GC (nine patients) or EGJ (seven patients). LM were considered technically unresectable in nine patients. Radiological response to the whole neoadjuvant program was achieved in 13 patients. Eight patients underwent surgical resection of the primary tumor; in five of these LM were resected. A complete pathological response in the primary or in the LM was found in four and three patients, respectively. The most frequent site of relapse/progression was systemic (eight patients). Local and liver-only relapses were observed in two patients each. After a median follow-up of 91 months, the median OS and PFS were 23.0 (95% CI 13.2–32.8) and 17.0 months (95% CI 11.7–22.3). 5-year actuarial PFS is 17.6%.

Conclusion

Our results suggest that an intensified approach using ICT followed by CRT in synchronous LM from GC/EGJ adenocarcinoma is feasible and may translate into prolonged survival times in selected patients.

Keywords

Gastric cancer Synchronous liver metastases Salvage surgery Neoadjuvant Chemoradiotherapy 

Notes

Compliance with ethical standards

Funding

This study has not received any funding.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable standards.

Informed consent

For this type of study formal consent is not required

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2017

Authors and Affiliations

  1. 1.Department of Oncology, Unit for the Research and Treatment of Gastrointestinal CancerClínica Universidad de Navarra, University of NavarraPamplonaSpain
  2. 2.Department of Surgery, Unit for the Research and Treatment of Gastrointestinal CancerClínica Universidad de Navarra, University of NavarraPamplonaSpain
  3. 3.Department of Pathology, Unit for the Research and Treatment of Gastrointestinal CancerClínica Universidad de Navarra, University of NavarraPamplonaSpain
  4. 4.Department of Endoscopy, Unit for the Research and Treatment of Gastrointestinal CancerClínica Universidad de Navarra, University of NavarraPamplonaSpain
  5. 5.Department of Liver Unit, Unit for the Research and Treatment of Gastrointestinal CancerClínica Universidad de Navarra, University of NavarraPamplonaSpain
  6. 6.Department of Radiology, Unit for the Research and Treatment of Gastrointestinal CancerClínica Universidad de Navarra, University of NavarraPamplonaSpain

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