胃癌肝转移的手术切除：22例患者17年经验分析
Surgical resection of liver metastases of gastric cancer: an analysis of a 17-year experience with 22 patients.
作者信息
Sakamoto Yoshihiro, Ohyama Shigekazu, Yamamoto Junji, Yamada Kazuhiko, Seki Makoto, Ohta Kei-ichiro, Kokudo Norihiro, Yamaguchi Toshiharu, Muto Tetsuichiro, Makuuchi Masatoshi
机构信息
Department of Surgery, Cancer Institute Hospital and Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
出版信息
Surgery. 2003 May;133(5):507-11. doi: 10.1067/msy.2003.147.
BACKGROUND
The justification for surgical resection of liver metastases from gastric cancer remains controversial.
METHODS
Twenty-two patients who underwent 26 hepatectomies for liver metastases of gastric cancer between 1985 and 2001 were analyzed. Fifteen clinicopathologic factors were evaluated with univariate and multivariate analyses for survival after hepatic resection.
RESULTS
The overall 1-year, 3-year, and 5-year survival rates after hepatectomy for gastric metastases were 73%, 38%, and 38%, respectively. Five patients survived for more than 3 years without recurrence, 3 of whom had synchronous metastases resected at the time of gastrectomy. The best results after surgical resection for liver metastases of gastric cancer were obtained with solitary metastases less than 5 cm in size. The number of liver metastases (solitary or multiple) was the only significant prognostic factor according to both univariate and multivariate analyses.
CONCLUSION
Surgical resection for liver metastases of gastric cancer may be beneficial for patients with a solitary metastasis, whether it is synchronous or metachronous.
背景
胃癌肝转移行手术切除的合理性仍存在争议。
方法
分析了1985年至2001年间22例因胃癌肝转移接受26次肝切除术的患者。对15个临床病理因素进行单因素和多因素分析，以评估肝切除术后的生存率。
结果
胃癌转移灶肝切除术后1年、3年和5年的总生存率分别为73%、38%和38%。5例患者存活超过3年且无复发，其中3例在胃切除时切除了同时性转移灶。胃癌肝转移手术切除后，以直径小于5 cm的孤立转移灶效果最佳。根据单因素和多因素分析，肝转移灶数量（孤立或多发）是唯一显著的预后因素。
结论
胃癌肝转移手术切除可能对孤立转移患者有益，无论其为同时性还是异时性转移。
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