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伴有肝转移的胃癌的预后研究。

Prognostic studies on gastric cancer with concomitant liver metastases.

作者信息

Fujisaki S, Tomita R, Nezu T, Kimizuka K, Park E, Fukuzawa M

机构信息

First Department of Surgery, Nihon University School of Medicine, 30-1, Oyaguchikamimachi, Itabashi-ku, Tokyo 173, Japan.

出版信息

Hepatogastroenterology. 2001 May-Jun;48(39):892-4.

Abstract

BACKGROUND/AIMS: The aim of this study was to clarify prognostic factors after surgical treatments in gastric cancer patients having synchronous liver metastases.

METHODOLOGY

Clinicopathological features and prognosis were retrospectively reviewed in 43 surgical patients with gastric cancer with concomitant liver metastases from 1984 to 1998.

RESULTS

More than half of the patients (51.2%) had numerous liver metastases (H3). Rates of peritoneal metastases (P1, P2, P3: 34.9%), tumor serosal invasion (T3 or T4: 73.8%) and widespread lymph node metastases (N3, N4: 69.8%) were also high. Although the gastric resection was performed in 29 patients (67.5%), concomitant hepatectomy resection was performed in only 3 patients (7.0%). Univariate analysis revealed that the grade of liver metastases (H1, H2, H3) was only a statistically significant prognostic factor (P = 0.008). Concerning surgical treatments, the resection group had tendency to better survival than the nonresection group (P = 0.074). Eight cases survived more than 1 year. Seven of the 8 cases (87.5%) were patients with gastrectomy. All of the 5 two-year survivors were patients with gastrectomy.

CONCLUSIONS

In patients with gastric cancer with concomitant liver metastases, the grade of liver metastases indicate prognosis. In addition, there is possibility of palliative gastrectomy increasing the survival rare to more than one year.

摘要

背景/目的:本研究旨在阐明伴有同步肝转移的胃癌患者手术治疗后的预后因素。

方法

回顾性分析了1984年至1998年间43例伴有肝转移的胃癌手术患者的临床病理特征及预后情况。

结果

超过半数患者(51.2%)有多发肝转移(H3)。腹膜转移率(P1、P2、P3:34.9%)、肿瘤浆膜侵犯(T3或T4:73.8%)及广泛淋巴结转移(N3、N4:69.8%)也较高。虽然29例患者(67.5%)接受了胃切除术,但仅3例患者(7.0%)同时进行了肝切除术。单因素分析显示,肝转移分级(H1、H2、H3)是唯一具有统计学意义的预后因素(P = 0.008)。关于手术治疗,切除组的生存趋势优于未切除组(P = 0.074)。8例患者存活超过1年。这8例患者中有7例(87.5%)接受了胃切除术。所有存活2年的患者均接受了胃切除术。

结论

对于伴有肝转移的胃癌患者,肝转移分级可提示预后。此外,姑息性胃切除术有可能将生存几率提高至超过1年。

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