Management of liver metastases from gastric carcinoma: where is the evidence?

BACKGROUND: Liver metastases of gastric carcinoma are often the synonym of advanced neoplastic disease which has long justified the indication of palliative chemotherapy. However, inspired by the good results of the management of liver metastases of colorectal cancers,several surgeons have focused on the treatment of liver metastases of gastric carcinoma. The different therapeutic modalities used are surgery, radiofrequency ablation, hepatic arterial infusion and palliative gastrectomy. AIMS: To provide evidence based answer to the following questions regarding liver metastases from gastric carcinoma: 1. What is the indication of surgery? 2. Does radiofrequency ablation useful? 3. What is the contribution of the hepatic arterial infusion? 4. Is there any benefit to palliative gastrectomy? METHODS: A literature search on PubMed database over the period from January 1990 to December 2011 was conducted using as key words "gastric cancer" and "liver metastases". RESULTS: Surgery of a single liver metastasis smaller than 5 cm and not associated with another metastatic site offers better results in terms of 5-year survival rate than palliative chemotherapy. Intra hepatic arterial chemotherapy offers an alternative to surgery in inoperable patients and can be proposed as neo adjuvant treatment to surgery. The interest of radiofrequency ablation and palliative gastrectomy remains unproven. CONCLUSION: Surgery is a good indication for single liver metastasis of gastric carcinoma less than 5 cm and not associated with another extra hepatic metastasis.

Enhancing scholarly discourse in the age of artificial intelligence: A guided approach to effective peer review process.

The integrity of the peer-review process (PRP) is paramount in academic publishing and serves as a critical filter for scholarly output. This mini-review centers on the introduction of comprehensive guidelines, presented in tables format, aimed at streamlining the interactions between authors and reviewers during the PRP. These guidelines, derived from an in-depth exploration of the PRP, offer structured and practical advice to ensure constructive, transparent, and effective communication, especially related to the use of artificial intelligence. While this mini-review discusses the strengths and challenges of the current PRP, its primary focus is on providing tangible recommendations to enhance the quality and efficiency of the PRP. By providing explicit guidelines and emphasizing the cooperative essence of peer review, this mini-review aims to improve the PRP, ensuring that it remains a robust mechanism for upholding the highest standards of research and knowledge dissemination in an evolving academic setting.