Takada Y, Otsuka M, Seino K, Taniguchi H, Koike N, Kawamoto T, Koda K, Adachi S, Yuzawa K, Nozue M, Todoroki T, Fukao K
Department of Surgery, Institute of Clinical Medicine, Tsukuba University, Ten-nodai 1-1-1, Tsukuba, Ibaraki 305-8575, Japan.
Hepatogastroenterology. 2001 Jan-Feb;48(37):83-6.
BACKGROUND/AIMS: The role of liver resection for hepatic metastases from noncolorectal carcinomas has yet to be clarified. The present study examines a single institutional experience of hepatic resection for noncolorectal metastases.
From January 1987 to March 1999, 14 patients underwent curative resection for liver metastases from noncolorectal carcinomas. Records of these patients were reviewed.
Resections were performed for liver metastases from gastric cancers (n = 8), pancreatic cancers (n = 2), and cancers of bile duct, the papilla of Vater, kidney, and breast (n = 1, each). Six patients (5 with gastric cancers and 1 with pancreas cancer) presented with synchronous disease and 8 with metachronous disease. In the gastric cancer patients, there are 2 disease-free survivors (26 and 53 months) in the metachronous group, though all of the 5 patients with synchronous disease died within 29 months. All of the 4 patients with pancreatobiliary carcinomas died within 2 years. One case of breast cancer and another of renal cell cancer are alive without disease at 49 and 9 months, respectively.
For metastases from gastric cancers, better survival after hepatic resection is expected in metachronous cases than in synchronous cases. Hepatic resection may afford little benefit for patients with liver metastases from pancretobiliary cancers.
背景/目的：肝切除治疗非结直肠癌肝转移的作用尚未明确。本研究探讨了单中心肝切除治疗非结直肠癌肝转移的经验。
1987年1月至1999年3月，14例患者接受了非结直肠癌肝转移的根治性切除。回顾了这些患者的记录。
肝转移瘤切除术用于治疗胃癌（n = 8）、胰腺癌（n = 2）以及胆管癌、Vater乳头癌、肾癌和乳腺癌（各n = 1）的肝转移。6例患者（5例胃癌和1例胰腺癌）为同时性病变，8例为异时性病变。在胃癌患者中，异时性组有2例无病生存者（分别为26个月和53个月），而5例同时性病变患者均在29个月内死亡。4例胰胆管癌患者均在2年内死亡。1例乳腺癌患者和1例肾细胞癌患者分别在49个月和9个月时无病存活。
对于胃癌肝转移患者，异时性病例肝切除后的生存率有望高于同时性病例。肝切除对胰胆管癌肝转移患者可能益处不大。
