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[胃癌同期肝转移的肝切除术]

[Hepatic resection for synchronous liver metastases of gastric cancer].

作者信息

Kawasaki H, Shibata S, Suzuki H, Sasaki M

机构信息

Second Dept. of Surgery, School of Medicine, Hirosaki University.

出版信息

Gan To Kagaku Ryoho. 2001 Oct;28(11):1740-2.

Abstract

Since 1970, we have treated 125 patients with synchronous liver metastases from gastric cancer. We analyzed 4 of these 125 patients who underwent hepatic resection, and studied the indications for hepatic resection. There were 3 H1 patients and 1 H2 patient. Lateral segmentectomy was performed for 2 patients and partial segmentectomy was performed for 2 patients. Hepatic arterial infusion (HAI) chemotherapy followed by surgery was performed for patients, one of whom died of recurrence in the residual liver at 49 months. The other patient has survived without recurrence for 30 months. Two patients without HAI died after 11.3 months and 1.9 months, respectively. The survival time of 3 H1 patients who underwent hepatectomy was 30.2 months, while that of the other H1 patients without hepatectomy was 8.3 months. In conclusion, when local control is obtained during surgery and the liver metastasis is H1 in a patient with synchronous liver metastasis of gastric cancer, aggressive hepatectomy supported by HAI should be performed to improve the prognosis.

摘要

自1970年以来,我们共治疗了125例胃癌同时性肝转移患者。我们分析了这125例中接受肝切除的4例患者,并研究了肝切除的指征。其中有3例H1期患者和1例H2期患者。2例行肝左外叶切除术,2例行部分肝段切除术。患者接受了肝动脉灌注(HAI)化疗后再行手术,其中1例在术后49个月死于残留肝脏复发。另1例患者存活30个月无复发。2例未接受HAI的患者分别在11.3个月和1.9个月后死亡。3例行肝切除的H1期患者生存时间为30.2个月,而其他未行肝切除的H1期患者生存时间为8.3个月。总之,对于胃癌同时性肝转移患者,若术中实现了局部控制且肝转移为H1期,应行HAI支持下的积极肝切除术以改善预后。

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