• Journal of Gastric Cancer
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• v.6 no.4
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• pp.237-243
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• 2006

Purpose: This study was conducted to evaluate the treatment outcomes and the prognosis for gastric cancer patients with hepatic metastasis. Materials and Methods: This retrospective study was based on the medical records of 85 gastric cancer patients with hepatic metastasis (62 synchronous and, 23 metachronous) who received chemotherapy with or without resectional therapy from March 1990 to March 2006. The survival rate was analyzed according to clinicopathologic factors and therapeutic factors, such as whether or not a gastrectomy, a hepatic resection, and/or chemotherapy had been performed. Results: The median survival of gastric cancer patients with hepatic metastasis was 11 months (synchronous: 11 months and metachronous: 17 months). The rates of gastrectomies and hepatic resections in the synchronous group were 24.1% and 16.1%, respectively A 23.5% prevalence of extra-hepatic metastasis was observed. The median survivals of patients who underwent a gastrectomy with a hepatic resection, a gastrectomy alone, and non-surgical treatment were 60, 18, and 9 months, respectively (P<0.05). The disease-free median survival of the metachronous group was 8 ($3{\sim}39$) months. There was no difference in initial pathologic stage and frequency of hepatic metastasis after the gastrectomy in the metachronous group. In the synchronous group, extra-hepatic metastasis, a gastrectomy as the operative procedure, a hepatic resection as the operative procedure and the response to chemotherapy were statistically significant in the univariate analysis, and a hepatic resection as the operative procedure, the response to chemotherapy, and extra-hepatic metastasis were independant prognostic factors identified by the multivariate analysis. In the metachronous group, extra-hepatic metastasis, the response to chemotherapy and differentiation were statistically significant in the univariate analysis, and extra-hepatic metastasis was an independent prognostic factor identified by the multivariate analysis. Conclusion: An aggressive surgical therapy and effective chemotherapy are necessary in the treatment of gastric cancer patients with hepatic metastasis. (J Korean Gastric Cancer Assoc 2006;6:237-243)

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.14-17
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• 2009

The clinical significance of hepatic resection for gastric metastases is controversial, even though hepatic resection has been widely accepted as a modality for colorectal metastases. Very few patients with gastric hepatic metastases are good candidates for hepatic resection because of multiple bilateral metastases, extrahepatic disease, or advanced cancer progression, such as peritoneal dissemination or extensive lymph node metastases. Therefore, several authors have reported the clinical significance of hepatic resection for gastric metastases in a small number of patients. Considering the present results with previous reports. The number and distribution of tumors in hepatic metastases from gastric cancer was considered based on the present and previous reports. Several authors have reported significantly better survival in patients with metachronous metastasis than in those with synchronous disease. However, metachronous hepatic resection necessitates the dissection of adhesions between the pancreas, liver, and residual stomach to prepare for Pringle's maneuver. Patients with unilobar liver metastasis, and/or metastatic tumors <4 cm in diameter may be good candidates for hepatic resection. Synchronous metastasis is not a contraindication for hepatic resection. Most of the long-term survivors underwent anatomic hepatic resection with a sufficient resection margin. After hepatic resection, the most frequent site of recurrence was the remaining liver, which was associated with a high frequency of mortality within 2 years. A reasonable strategy for improvement in survival would be to prevent recurrence by means of adjuvant chemotherapy and careful follow-up studies.

• Korean Journal of Veterinary Research
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• v.53 no.1
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• pp.61-64
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• 2013

A ten-year-old dog was presented with pancreatitis and increased hepatic enzymes. On necropsy a large firm mass was observed in the liver extending to the gall bladder. Smaller masses with similar texture were found in multiple organs including lung, stomach, pancreas, lymph nodes, omentum, and mesentery. Neoplastic cells were spindle shaped with prominent osteoid production and occasional trabeculae of woven bone. Tumor cell emboli were observed in the blood vessels and lymphatics of the omentum and stomach. Hepatic osteosarcoma with systemic metastasis is very rare and may serve to broaden the diagnostic spectrum of hepatic and pancreatic diseases in dogs.

• Korean Journal of Radiology
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• v.1 no.3
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• pp.165-168
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• 2000

We present two cases of solitary necrotic nodules of the liver which on radiologic images mimicked hepatic metastasis. Solitary necrotic nodule of the liver is a rare but benign entity which histopathologically consists of an outer fibrotic capsule with inflammatory cells and a central core of amorphous necrotic material. The lesion was seen on contrast-enhanced CT as an ovoid-shaped hypoattenuating nodule; on CT during hepatic arteriography as enhancing nodule; on intraoperative US as a target-appearing hypoechoic nodule; on T2WI as a hyperintensity nodule, and on dynamic MR as a subtle peripheral enhancing nodule. Although the radiologic features are not specific, solitary necrotic nodule of the liver should be included in the differential diagnosis of hepatic metastasis.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.3
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• pp.253-255
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• 2008

A 61-year-old man had a F-18 FDG PET/CT scan for evaluation of a common bile duct cancer identified on CT. The PET/CT image showed a hypermetabolic mass in the common bile duct, and a focal area of increased F-18 FDG uptake in segment IV of the liver, which corresponded to a hypoattenuated lesion on non-enhanced CT, and was consistent with hepatic metastasis. The patient underwent choledochojejunostomy with hepatic resection, and pathologic findings were compatible with an eosinophilic abscess in the liver. This case demonstrates that F-18 FDG uptake by an eosinophilic abscess can mimic hepatic metastasis in a patient with a malignancy.

• Journal of Veterinary Clinics
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• v.23 no.2
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• pp.194-196
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• 2006

A leiomyosarcoma that occurred in the right kidney with hepatic metastasis of a 15-year-old intact female Asian water buffalo (Bubalus arnee) in a zoo, Republic of Korea. The animal showed no clinical signs. Grossly, a firm and white mass (6.0 x- 5.0- x 4.0 cm) was observed in the renal capsule and multiple firm white nodules, measuring 1.0-2.5 cm, were present on the surface of the liver. Microscopically, tumor cells were spindle-shaped, the cell density was high, and complex fasciculated tumor cells showing longitudinal and transverse cross-sections were observed. Tumor cell nuclei was ordinarily cigar shaped and had rounded blunt ends. Immunohistochemically, tumor cells reacted intensely with anti-smooth muscle actin antibody. This is the first case report of a renal leiomyosarcoma with hepatic metastasis in a Asian water buffalo.

• Korean Journal of Clinical Oncology
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• v.14 no.2
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• pp.142-145
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• 2018

Metastases to the liver can be found in various malignancies, most commonly originating from the colon, rectum, pancreas, stomach, esophagus, breast, lung, and melanoma. Surgical resection of liver metastasis is generally considered to be the definitive therapy fore cure. However, many patients are unable to undergo surgical resection due to medical comorbidities or multifocal extent of malignant disease affecting the liver. Among patients not eligible for surgery, other therapies exist for treatment in order to down stage the disease for surgical resection or for palliation. Radioembolization of hepatic metastases has shown to improve outcomes among patients with variety of malignancies including more common malignancies such as colorectal cancer. Yttrium-90 (Y-90) radioembolization has been successfully used in the management of hepatic metastases. A small series of metastatic sarcoma to the liver treated with radioembolization showed a promising response. We report a case of metastatic gastric leiomyosarcoma to the liver treated with Y-90 glass microspheres therapy using the radiation segmentectomy approach, previously described for hepatocellular carcinoma.

• Journal of Digestive Cancer Research
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• v.3 no.1
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• pp.26-29
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• 2015

A 73-year-old male visited our hospital with a complaint of general weakness. He underwent pyloric preserving pancreas-toduodenectomy due to ampullary cancer three years ago. Abdominal computed tomography scan at initial visit revealed multiple hepatic masses. A PET-CT scan showed multiple FDG uptakes at whole liver. He underwent hepatic artery infusion chemotherapy (HAIC) for five cycles. During the first cycle of HAIC, he developed gastric ulcer bleeding and endoscopic hemostasis was done successfully. Esophagogastroduodenoscopy after the 5^th cycle of HAIC revealed ulcer scar at gastric angle. PET-CT scan at 12 months showed no FDG uptake at liver, but a focal FDG uptakes at stomach and peri-gastric lymph nodes were newly developed. Esophagogastroduodenoscopy revealed about 3 cm sized mass at gastric angle. He underwent surgery and pathologic examination revealed large cell neuroendocrine carcinoma. We report a case of gastric large cell neuroendocrine carcinoma with liver metastasis treated with HAIC followed by surgery.

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.10-13
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• 2009

The prognosis of gastric cancer with hepatic metastasis is very poor, even though several treatment modalities exist, such as surgical resection. Indeed, a standard therapy has not been established in such patients. Recently, attempts were made to treat hepatic metastasis of gastric cancer with radiofrequency (RF), which was originally used in primary or metastatic liver cancer. RF has been reported to show similar survival compared to surgical resection and is emerging as a new treatment modality even though it is still not conclusive with respect to efficacy and safety due to the paucity of reports. A prospective study is warranted to evaluate the efficacy of RF in the treatment of gastric cancer with hepatic metastasis compared with conventional modalities.

• Journal of Acupuncture Research
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• v.23 no.6
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• pp.45-60
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• 2006

Objectives : This study was guided to estimate inhibitory effects against hepatic metastasis and activation of immunocytes by Carthami Semen Herbal Acupuncture. Methods : Colon26-L5 carcinoma cells were injected through hepatic portal vein to induce hepatic metastatic cancer. Changes in weight, morphology of the cancer were estimated and cytokine level was analyzed to produce immunological changes. Results: The experimental group was significantly decreased metastatic size and proliferation compared with the control group. Observing immunocytes from the spleen of experimental group T-lymphocytes were significantly increased. As compared with control group, the differentiation of total T cell, helper T cell, cytotoxic T cell, Macrophage and NK cell was increased. Measuring the level of cytokine $IFN-{\gamma}$ which stimulates Th 1 was significantly increased in splenocyte with Con A stimuli. $IFN-{\gamma}$ and IL-12 were significantly increased in peritoneal exudate macrophage with LPS stimuli. Conclusion : These findings strongly indicate Carthami Semen Herbal Acupuncture improves immunity to inhibit the growth of cancer and metastasis.