Current status and clinical challenges in diagnosis and treatment of gastric cancer liver metastasis

Gastric cancer liver metastasis (GCLM) has long been a core challenge in the management of gastric cancer owing to its high incidence, profound heterogeneity, and extremely poor prognosis. Over the past decade, advances in tumor molecular research, diagnostic innovation, and the progressive refinement of comprehensive therapy have laid a critical foundation for building precision oncology frameworks. However, key bottlenecks persist: clinical translation of molecular classification lags behind, the population likely to benefit from conversion therapy is not well delineated, and surgical indications still lack high‑level medicine evidence, collectively limiting meaningful survival improvement. The authors examine three core dimensions of GCLM-patho-genesis and molecular characteristics, diagnostic evaluation and risk prediction, and individualized stratified treatment strategies-to clarify the current landscape, pinpoint major controversies, and outline avenues for extending survival.