**Gastric Cancer with Liver Metastasis (GCLM) and the Importance of Dormant Cancer Stem Cells**

Vitězslav Marek and Štefan Durdik

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.69829

#### **Abstract**

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620-627. DOI: 10.1001/jamaoncol.2016.5580

242 Gastric Cancer

**8**:e54014. DOI: 10.1371/journal.pone.0054014

Surgical treatment of gastric cancer with liver metastasis (GCLM) is even more interested for oncologists. Liver resection or RFA (radiofrequency ablation) is not commonly indicated in gastric cancer with liver metastasis (GCLM). There is no direct marker defining the degree of biological aggressiveness of the tumor (indicating or contraindicating the surgical treatment), therefore we are left to rely on indirect prognostic factors: 1. cancerous invasion in the gastric wall serosa; 2. the presence of three and more liver metastases; 3. the size of metastasis exceeding 50 mm. Clarification of the nature of biological behavior of gastric cancer is a turning point of this treatment. Small light in explanation of the above problem is cancer stem cells (CSCs) theory. This theory proposes that CSCs serve not only as the basis for the development and progression of tumors, but also as the primary reason for tumor recurrence and metastasis. A better understanding of CSCs' contribution to clinical tumor dormancy and metastasis will provide new therapeutic revenues to eradicate metastatic tumors and significantly reduce the mortality of cancer patients.

**Keywords:** gastric cancer with liver metastasis (GCLM), radiofrequency ablation (RFA), cancer stem cells (CSCs), metastasis, tumor dormancy, cell dormancy, epithelialmesenchymal transition (EMT)
