Patients and Treatment

From January 1998 to December 2013, a total of 50 patients underwent combined surgical resection of both the liver metastases and primary gastric cancer in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital. We retrospectively collected their demographic and clinicopathologcial data from the medical records. Eligibility criteria included: (1) the primary gastric cancer and the liver metastatic lesions should be removed in the same operation; (2) histologically confirmed R0 resection; (3) diagnosis of gastric adenocarcinoma should be confirmed by pathological examination of the resected specimen; (4) liver metastasis from the gastric adenocarcinoma should be pathologically confirmed. Exclusion criteria included: (1) evidence of peritoneal metastases or other extrahepatic metastases before or during the operation; (2) primary gastric cancer with direct infiltration to the liver; (3) patients lost to follow-up. After screening the potential eligible patients, one patient was excluded because of the positive surgical margin (R1 resection); another patient was excluded because the pathological examination of the specimen proved to be gastric neuroendocrine cancer; two patients were excluded as they were lost to follow-up. Thus, a total of 37 patients from Cancer Hospital, Chinese Academy of Medical Sciences and 9 patients from Peking Union Medical College Hospital were finally enrolled into our study (Figure ​(Figure1).1). Patients’ informed consent was not required owing to the retrospective nature of the study.

The flowchart describing the selection of the patients.

Pathologic data were retrieved from the medical records. In the two medical institutions, pathological examinations of the specimen were performed with adherence to the General Rules of the Japanese Gastric Cancer Association (JGCA)⁵ and to the current NCCN guideline.