Simultaneous Resection of Gastric Primary Tumour and Synchronous Liver Metastases: Survival Analysis

Gastric carcinoma is the major cause of cancer related deaths in China (Zhang et al., 2014). Due to the unspecific symptoms at an early stage and lack of a screening schedule, the majority of patients with gastric cancer are diagnosed at an advanced stage. Liver is a frequent organ of distant metastases from gastric cancer, and the incidence of liver metastases from primary gastric cancer ranges from 5 to 9% (Thelen et al., 2008). The effect of surgical resection of liver metastasis from gastric cancer remains unclear. A key question was whether simultaneous resection of liver metastases provided any long-term survival benefit. Because patients with liver metastases from gastric carcinoma usually associated with extrahepatic disease, such as peritoneal dissemination, lymph node metastasis, and direct cancer invasion of other organs (Ambiru et al., 2001; Morise et al., 2008; Tiberio et al., 2009), only a few of them are candidates for hepatic resection. There is increasing