Skip to main content
Erschienen in: Gastric Cancer 2/2014

01.04.2014 | Review Article

Surgical resection of hepatic metastasis from gastric cancer: a review and new recommendation in the Japanese gastric cancer treatment guidelines

verfasst von: Yasuhiro Kodera, Kazumasa Fujitani, Norimasa Fukushima, Seiji Ito, Kei Muro, Norifumi Ohashi, Takaki Yoshikawa, Daisuke Kobayashi, Chie Tanaka, Michitaka Fujiwara

Erschienen in: Gastric Cancer | Ausgabe 2/2014

Einloggen, um Zugang zu erhalten

Abstract

Liver metastases from gastric cancer are rarely indicated for surgery because they are often diagnosed as multiple nodules occupying both lobes and coexist with extrahepatic disease. A literature search identified no clinical trials on hepatectomy for this disease; only retrospective studies of a relatively small number of cases collected over more than a decade, mostly from a single institution, were found. Five-year survival rates from these reports ranged from 0 % to 37 %, and long-term survivors were observed among carefully selected case series. The most commonly reported prognostic factor was the number of metastatic nodules, and patients with a solitary metastasis tended to have superior outcome. Patients diagnosed to have a small number of metastatic nodules by modern imaging tools could be indicated for surgery. Because both intrahepatic and extrahepatic recurrences are common, patients are likely to benefit from perioperative adjuvant chemotherapy, although it is not possible at this time to specify which regimen is the most appropriate.
Literatur
1.
Zurück zum Zitat Shimada H, Tanaka K, Endou I, Ichikawa Y. Treatment for colorectal liver metastases: a review. Langenbecks Arch Surg. 2009;394:973–83.PubMedCrossRef Shimada H, Tanaka K, Endou I, Ichikawa Y. Treatment for colorectal liver metastases: a review. Langenbecks Arch Surg. 2009;394:973–83.PubMedCrossRef
2.
Zurück zum Zitat Adam R, Chice L, Aloia T, Elias D, Salmon R, Rivoire M, et al. Hepatic resection for noncolorectal nonendocrine liver metastases. Analysis of 1425 patients and development of a prognostic model. Ann Surg. 2006;244:524–35.PubMedCentralPubMedCrossRef Adam R, Chice L, Aloia T, Elias D, Salmon R, Rivoire M, et al. Hepatic resection for noncolorectal nonendocrine liver metastases. Analysis of 1425 patients and development of a prognostic model. Ann Surg. 2006;244:524–35.PubMedCentralPubMedCrossRef
3.
Zurück zum Zitat Langley RR, Fidler IJ. The seed and soil hypothesis revisited: the role of tumor–stroma interactions in metastasis to different organs. Int J Cancer. 2011;128:2527–35.PubMedCentralPubMedCrossRef Langley RR, Fidler IJ. The seed and soil hypothesis revisited: the role of tumor–stroma interactions in metastasis to different organs. Int J Cancer. 2011;128:2527–35.PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Kodera Y, Ito S, Mochizuki Y, Yamamura Y, Misawa K, Ohashi N, et al. The number of metastatic lymph nodes is a significant risk factor for bone metastasis and poor outcome after surgery for linitis plastica-type gastric carcinoma. World J Surg. 2008;32:2015–20.PubMedCrossRef Kodera Y, Ito S, Mochizuki Y, Yamamura Y, Misawa K, Ohashi N, et al. The number of metastatic lymph nodes is a significant risk factor for bone metastasis and poor outcome after surgery for linitis plastica-type gastric carcinoma. World J Surg. 2008;32:2015–20.PubMedCrossRef
5.
Zurück zum Zitat Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines (ver. 3). Gastric Cancer. 2010;2011(14):113–23. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines (ver. 3). Gastric Cancer. 2010;2011(14):113–23.
6.
Zurück zum Zitat Takemura N, Saiura A, Koga R, Arita J, Yoshioka R, Ono Y, et al. Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections. Langenbecks Arch Surg. 2012;397:951–7.PubMedCrossRef Takemura N, Saiura A, Koga R, Arita J, Yoshioka R, Ono Y, et al. Long-term outcomes after surgical resection for gastric cancer liver metastasis: an analysis of 64 macroscopically complete resections. Langenbecks Arch Surg. 2012;397:951–7.PubMedCrossRef
7.
Zurück zum Zitat Shirabe K, Shimada M, Matsumata T, Higashi H, Yakeishi Y, Wakiyama S, et al. Analysis of the prognostic factors for liver metastasis of gastric cancer after hepatic resection: a multi-institutional study of the indication for resection. Hepatogastroenterology. 2003;50:1560–3.PubMed Shirabe K, Shimada M, Matsumata T, Higashi H, Yakeishi Y, Wakiyama S, et al. Analysis of the prognostic factors for liver metastasis of gastric cancer after hepatic resection: a multi-institutional study of the indication for resection. Hepatogastroenterology. 2003;50:1560–3.PubMed
8.
Zurück zum Zitat Wang Y-N, Shen K-T, Ling J-Q, Gao X-D, Hou Y-Y, Wang X-F, et al. Prognostic analysis of combined curative resection of the stomach and liver lesions in 30 gastric cancer patients with synchronous liver metastases. BMC Surg. 2012;12:20.PubMedCentralPubMedCrossRef Wang Y-N, Shen K-T, Ling J-Q, Gao X-D, Hou Y-Y, Wang X-F, et al. Prognostic analysis of combined curative resection of the stomach and liver lesions in 30 gastric cancer patients with synchronous liver metastases. BMC Surg. 2012;12:20.PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Cheon SH, Rha SY, Jeung HC, Im CK, Kim SH, Kim HR, et al. Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases. Ann Oncol. 2008;19:1146–53.PubMedCrossRef Cheon SH, Rha SY, Jeung HC, Im CK, Kim SH, Kim HR, et al. Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases. Ann Oncol. 2008;19:1146–53.PubMedCrossRef
10.
Zurück zum Zitat Makino H, Kunisaki C, Izumisawa Y, Tokuhisa M, Oshima T, Nagano Y, et al. Indication for hepatic resection in the treatment of liver metastasis from gastric cancer. Anticancer Res. 2010;30:2367–76.PubMed Makino H, Kunisaki C, Izumisawa Y, Tokuhisa M, Oshima T, Nagano Y, et al. Indication for hepatic resection in the treatment of liver metastasis from gastric cancer. Anticancer Res. 2010;30:2367–76.PubMed
11.
Zurück zum Zitat Ambiru S, Miyazaki M, Ito H, Nakagawa K, Shimizu H, Yoshidome H, et al. Benefits and limits of hepatic resection for gastric metastases. Am J Surg. 2001;151:279–83.CrossRef Ambiru S, Miyazaki M, Ito H, Nakagawa K, Shimizu H, Yoshidome H, et al. Benefits and limits of hepatic resection for gastric metastases. Am J Surg. 2001;151:279–83.CrossRef
12.
Zurück zum Zitat Okano K, Maeba T, Ishimura K, Karasawa Y, Goda F, Wakabayashi H, et al. Hepatic resection for metastatic tumors from gastric cancer. Ann Surg. 2002;235:86–91.PubMedCentralPubMedCrossRef Okano K, Maeba T, Ishimura K, Karasawa Y, Goda F, Wakabayashi H, et al. Hepatic resection for metastatic tumors from gastric cancer. Ann Surg. 2002;235:86–91.PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Zacherl J, Zacherl M, Scheuba C, Steininger R, Wenzl E, Muhlbacher F, et al. Analysis of hepatic resection of metastasis originating from gastric adenocarcinoma. J Gastrointest Surg. 2002;6:682–9.PubMedCrossRef Zacherl J, Zacherl M, Scheuba C, Steininger R, Wenzl E, Muhlbacher F, et al. Analysis of hepatic resection of metastasis originating from gastric adenocarcinoma. J Gastrointest Surg. 2002;6:682–9.PubMedCrossRef
14.
Zurück zum Zitat Sakamoto Y, Sano T, Shimada K, Esaki M, Saka M, Fukagawa T, et al. Favorable indications for hepatectomy in patients with liver metastasis from gastric cancer. J Surg Oncol. 2007;95:534–9.PubMedCrossRef Sakamoto Y, Sano T, Shimada K, Esaki M, Saka M, Fukagawa T, et al. Favorable indications for hepatectomy in patients with liver metastasis from gastric cancer. J Surg Oncol. 2007;95:534–9.PubMedCrossRef
15.
Zurück zum Zitat Morise Z, Sugiokla A, Hoshimoto S, Kato T, Ikeda M, Uyama I, et al. The role of hepatectomy for patients with liver metastases of gastric cancer. Hepatogastroenterology. 2008;55:1238–41.PubMed Morise Z, Sugiokla A, Hoshimoto S, Kato T, Ikeda M, Uyama I, et al. The role of hepatectomy for patients with liver metastases of gastric cancer. Hepatogastroenterology. 2008;55:1238–41.PubMed
16.
Zurück zum Zitat Thelen A, Jonas S, Benckert C, Lopez-Hanninen E, Neumann U, Rudolph B, et al. Liver resection for metastatic gastric cancer. Eur J Surg Oncol. 2008;34:1328–34.PubMedCrossRef Thelen A, Jonas S, Benckert C, Lopez-Hanninen E, Neumann U, Rudolph B, et al. Liver resection for metastatic gastric cancer. Eur J Surg Oncol. 2008;34:1328–34.PubMedCrossRef
17.
Zurück zum Zitat Tsujimoto H, Ichikura T, Ono S, Sugasawa H, Hiraki S, Sakamoto N, et al. Outcomes for patients following hepatic resection of metastatic tumors from gastric cancer. Hepatol Int. 2010;4:406–13.PubMedCentralPubMedCrossRef Tsujimoto H, Ichikura T, Ono S, Sugasawa H, Hiraki S, Sakamoto N, et al. Outcomes for patients following hepatic resection of metastatic tumors from gastric cancer. Hepatol Int. 2010;4:406–13.PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Miki Y, Fujitani K, Hirao M, Kurokawa Y, Mano M, Tsujie M, et al. Significance of surgical treatment of liver metastases from gastric cancer. Anticancer Res. 2012;32:665–70.PubMed Miki Y, Fujitani K, Hirao M, Kurokawa Y, Mano M, Tsujie M, et al. Significance of surgical treatment of liver metastases from gastric cancer. Anticancer Res. 2012;32:665–70.PubMed
19.
Zurück zum Zitat Garancini M, Uggeri F, Degrate L, Nespoli L, Gianotti L, Nespoli A, et al. Surgical treatment of liver metastases of gastric cancer: is local treatment in a systemic disease worthwhile? HPB (Oxf). 2012;14:209–15.CrossRef Garancini M, Uggeri F, Degrate L, Nespoli L, Gianotti L, Nespoli A, et al. Surgical treatment of liver metastases of gastric cancer: is local treatment in a systemic disease worthwhile? HPB (Oxf). 2012;14:209–15.CrossRef
20.
Zurück zum Zitat Schildberg CW, Croner R, Merkel S, Schellerer V, Muller V, Yedibela S, et al. Outcome of operative therapy of hepatic metastatic stomach carcinoma: a retrospective analysis. World J Surg. 2012;36:872–8.PubMedCrossRef Schildberg CW, Croner R, Merkel S, Schellerer V, Muller V, Yedibela S, et al. Outcome of operative therapy of hepatic metastatic stomach carcinoma: a retrospective analysis. World J Surg. 2012;36:872–8.PubMedCrossRef
21.
Zurück zum Zitat Imamura H, Matsuyama Y, Shimada R, Kubota M, Nakayama A, Kobayashi A, et al. A study of factors influencing prognosis after resection of hepatic metastases from colorectal and gastric carcinoma. Am J Gastroenterol. 2001;96:3178–84.PubMedCrossRef Imamura H, Matsuyama Y, Shimada R, Kubota M, Nakayama A, Kobayashi A, et al. A study of factors influencing prognosis after resection of hepatic metastases from colorectal and gastric carcinoma. Am J Gastroenterol. 2001;96:3178–84.PubMedCrossRef
22.
Zurück zum Zitat Sarpel U, Bonavia AS, Grucela A, Roayaie S, Schwarz ME, Labow DM. Does anatomic versus nonanatomic resection affect recurrence and survival in patients undergoing surgery for colorectal liver metastasis? Ann Surg Oncol. 2009;16:379–84.PubMedCrossRef Sarpel U, Bonavia AS, Grucela A, Roayaie S, Schwarz ME, Labow DM. Does anatomic versus nonanatomic resection affect recurrence and survival in patients undergoing surgery for colorectal liver metastasis? Ann Surg Oncol. 2009;16:379–84.PubMedCrossRef
23.
Zurück zum Zitat Ajani JA, Barthel JS, Bekaii-Saab T, Bentrem DJ, D’Amico TA, Das P, et al. Gastric cancer. J Natl Compr Canc Netw. 2010;8:378–409.PubMed Ajani JA, Barthel JS, Bekaii-Saab T, Bentrem DJ, D’Amico TA, Das P, et al. Gastric cancer. J Natl Compr Canc Netw. 2010;8:378–409.PubMed
24.
25.
Zurück zum Zitat Maas M, Rutten IJG, Nelemans PJ, Lambregts DM, Cappendijk VC, Beets GL, et al. What is the most accurate whole-body imaging modality for assessment of local and distant recurrent disease in colorectal cancer? A meta-analysis. Eur J Nucl Med Mol Imaging. 2011;38:1560–71.PubMedCentralPubMedCrossRef Maas M, Rutten IJG, Nelemans PJ, Lambregts DM, Cappendijk VC, Beets GL, et al. What is the most accurate whole-body imaging modality for assessment of local and distant recurrent disease in colorectal cancer? A meta-analysis. Eur J Nucl Med Mol Imaging. 2011;38:1560–71.PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Sasako M, Sakuramoto S, Katai H, Kinoshita T, Furukawa H, Yamaguchi T, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol. 2011;29:4387–93.PubMedCrossRef Sasako M, Sakuramoto S, Katai H, Kinoshita T, Furukawa H, Yamaguchi T, et al. Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol. 2011;29:4387–93.PubMedCrossRef
27.
Zurück zum Zitat Bang YJ, Kim YW, Yang HK, Chung HC, Park YK, Lee KH, et al. Adjuvant vapecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet. 2012;379:315–21.PubMedCrossRef Bang YJ, Kim YW, Yang HK, Chung HC, Park YK, Lee KH, et al. Adjuvant vapecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet. 2012;379:315–21.PubMedCrossRef
28.
Zurück zum Zitat Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20.PubMedCrossRef Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20.PubMedCrossRef
29.
Zurück zum Zitat Li Z-Y, Tang L, Zhang L-H, Bu Z-D, Wu A-W, Wu X-J, et al. Weekly docetaxel and cisplatin plus fluorouracil as a preoperative treatment for gastric cancer with synchronous multiple hepatic metastasis: a pilot study. Med Oncol. 2010;27:1314–8.PubMedCrossRef Li Z-Y, Tang L, Zhang L-H, Bu Z-D, Wu A-W, Wu X-J, et al. Weekly docetaxel and cisplatin plus fluorouracil as a preoperative treatment for gastric cancer with synchronous multiple hepatic metastasis: a pilot study. Med Oncol. 2010;27:1314–8.PubMedCrossRef
30.
Zurück zum Zitat Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687–97.PubMedCrossRef Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687–97.PubMedCrossRef
31.
Zurück zum Zitat Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9:215–21.PubMedCrossRef Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9:215–21.PubMedCrossRef
32.
Zurück zum Zitat Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 2008;358:36–46.PubMedCrossRef Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 2008;358:36–46.PubMedCrossRef
33.
Zurück zum Zitat Ohtsu A, Shah MA, Van Cutsem E, Rha SY, Sawaki A, Park SR, et al. Bevacizumab in combination with chemotherapy as first-line therapy in advanced gastric cancer: a randomized, double-blind, placebo-controlled phase III study. J Clin Oncol. 2011;29:3968–76.PubMedCrossRef Ohtsu A, Shah MA, Van Cutsem E, Rha SY, Sawaki A, Park SR, et al. Bevacizumab in combination with chemotherapy as first-line therapy in advanced gastric cancer: a randomized, double-blind, placebo-controlled phase III study. J Clin Oncol. 2011;29:3968–76.PubMedCrossRef
34.
Zurück zum Zitat Narahara H, Ishii H, Imamura H, Tsuburaya A, Chin K, Imamoto H, et al. Randomized phase III study comparing the efficacy and safety of irinotecan plus S-1 with S-1 alone as first-line treatment for advanced gastric cancer (study GC0301/TOP-002). Gastric Cancer. 2011;14:72–80.PubMedCentralPubMedCrossRef Narahara H, Ishii H, Imamura H, Tsuburaya A, Chin K, Imamoto H, et al. Randomized phase III study comparing the efficacy and safety of irinotecan plus S-1 with S-1 alone as first-line treatment for advanced gastric cancer (study GC0301/TOP-002). Gastric Cancer. 2011;14:72–80.PubMedCentralPubMedCrossRef
35.
Zurück zum Zitat Yoshida M, Ohtsu A, Boku N, Miyata Y, Shirao K, Shimada Y, et al. Longterm survival and prognostic factors in patients with metastatic gastric cancers treated with chemotherapy in the Japan Clinical Oncology Group (JCOG) study. Jpn J Clin Oncol. 2004;34:654–9.PubMedCrossRef Yoshida M, Ohtsu A, Boku N, Miyata Y, Shirao K, Shimada Y, et al. Longterm survival and prognostic factors in patients with metastatic gastric cancers treated with chemotherapy in the Japan Clinical Oncology Group (JCOG) study. Jpn J Clin Oncol. 2004;34:654–9.PubMedCrossRef
36.
Zurück zum Zitat Kumada T, Arai Y, Itoh K, Takayasu Y, Nakamura K, Ariyoshi Y, et al. Phase II study of combined administration of 5-fluorouracil, epirubicin and mitomycin-C by hepatic artery infusion in patients with liver metastases of gastric cancer. Oncology. 1999;57:216–23.PubMedCrossRef Kumada T, Arai Y, Itoh K, Takayasu Y, Nakamura K, Ariyoshi Y, et al. Phase II study of combined administration of 5-fluorouracil, epirubicin and mitomycin-C by hepatic artery infusion in patients with liver metastases of gastric cancer. Oncology. 1999;57:216–23.PubMedCrossRef
37.
Zurück zum Zitat Ojima H, Ootake S, Yokobori T, Mochida Y, Hosouchi Y, Nishida Y, et al. Treatment of multiple liver metastasis from gastric carcinoma. World J Surg Oncol. 2007;5:70.PubMedCentralPubMedCrossRef Ojima H, Ootake S, Yokobori T, Mochida Y, Hosouchi Y, Nishida Y, et al. Treatment of multiple liver metastasis from gastric carcinoma. World J Surg Oncol. 2007;5:70.PubMedCentralPubMedCrossRef
38.
Zurück zum Zitat Inaba Y, Arai Y, Matsueda K, Takeuchi Y, Aramaki T. Right gastric artery embolization to prevent acute gastric mucosal lesions in patients undergoing repeat hepatic arterial infusion chemotherapy. J Vasc Interv Radiol. 2001;12:957–63.PubMedCrossRef Inaba Y, Arai Y, Matsueda K, Takeuchi Y, Aramaki T. Right gastric artery embolization to prevent acute gastric mucosal lesions in patients undergoing repeat hepatic arterial infusion chemotherapy. J Vasc Interv Radiol. 2001;12:957–63.PubMedCrossRef
39.
Zurück zum Zitat Kim HR, Cheon SH, Lee KH, Ahn JR, Jeung HC, Lee SS, et al. Efficacy and feasibility of radiofrequency ablation for liver metastases from gastric adenocarcinoma. Int J Hypertherm. 2010;26:305–13.CrossRef Kim HR, Cheon SH, Lee KH, Ahn JR, Jeung HC, Lee SS, et al. Efficacy and feasibility of radiofrequency ablation for liver metastases from gastric adenocarcinoma. Int J Hypertherm. 2010;26:305–13.CrossRef
40.
Zurück zum Zitat Kim HO, Hwang SI, Hong HP, Yoo CH. Radiofrequency ablation for metachronous hepatic metastases from gastric cancer. Surg Laparosc Endosc Percutan Tech. 2009;19:208–12.PubMedCrossRef Kim HO, Hwang SI, Hong HP, Yoo CH. Radiofrequency ablation for metachronous hepatic metastases from gastric cancer. Surg Laparosc Endosc Percutan Tech. 2009;19:208–12.PubMedCrossRef
41.
Zurück zum Zitat Yamakado K, Nakatsuka A, Takaki H, Mori Y, Tonouchi H, Kusunoki M, et al. Prospective study of arterial infusion chemotherapy followed by radiofrequency ablation for the treatment of liver metastasis of gastric cancer. J Vasc Interv Radiol. 2005;16:1747–51.PubMedCrossRef Yamakado K, Nakatsuka A, Takaki H, Mori Y, Tonouchi H, Kusunoki M, et al. Prospective study of arterial infusion chemotherapy followed by radiofrequency ablation for the treatment of liver metastasis of gastric cancer. J Vasc Interv Radiol. 2005;16:1747–51.PubMedCrossRef
42.
Zurück zum Zitat Weng M, Zhang Y, Zhou D, Yang Y, Tang Z, Zhao M, et al. Radiofrequency ablation versus resection for colorectal cancer liver metastases: a meta-analysis. PLoS One. 2012;7:e45493.PubMedCentralPubMedCrossRef Weng M, Zhang Y, Zhou D, Yang Y, Tang Z, Zhao M, et al. Radiofrequency ablation versus resection for colorectal cancer liver metastases: a meta-analysis. PLoS One. 2012;7:e45493.PubMedCentralPubMedCrossRef
Metadaten
Titel
Surgical resection of hepatic metastasis from gastric cancer: a review and new recommendation in the Japanese gastric cancer treatment guidelines
verfasst von
Yasuhiro Kodera
Kazumasa Fujitani
Norimasa Fukushima
Seiji Ito
Kei Muro
Norifumi Ohashi
Takaki Yoshikawa
Daisuke Kobayashi
Chie Tanaka
Michitaka Fujiwara
Publikationsdatum
01.04.2014
Verlag
Springer Japan
Erschienen in
Gastric Cancer / Ausgabe 2/2014
Print ISSN: 1436-3291
Elektronische ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-013-0299-x

Weitere Artikel der Ausgabe 2/2014

Gastric Cancer 2/2014 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.