Li Yu-ming, Zhan Wen-hua, Han Fang-hai, He Yu-long, Peng Jun-sheng, Cai Shi-rong, Ma Jin-ping, Zhao Gang
Department of Gastrointestinopancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2006 Mar;9(2):127-30.
To analyze the clinicopathological factors affecting synchronous liver metastasis in gastric cancer,and evaluate its surgical outcome.
Clinical data of 44 patients with synchronous hepatic metastasis from gastric cancer from Aug. 1994 to Feb. 2004 were reviewed retrospectively, and compared with those of 576 gastric cancer patients without hepatic metastasis to analyze the clinicopathological factors affecting synchronous liver metastasis from gastric cancer. The survivals after radical resection, palliative and exploratory operation were compared.
Univariate analysis revealed that ascites, pelvic and peritoneal seeding, serosal invasion, lymph node metastasis, involvement of neighboring organs, Borrmann types,depth of infiltration were correlated with synchronous hepatic metastasis from gastric cancer (P< 0.01). Logistic regression showed peritoneal seeding (P=0.003, OR=1.629), serosal infiltration (P=0.000, OR=3.000), lymph node metastasis (P=0.081, OR=1.689) were independent risk factors for synchronous hepatic metastasis from gastric cancer. Sixteen (36.4%) patients received radical excision, 15 (34.1%) patients palliative operation, and 13 (29.5 %) patients exploratory operation,and the median survival times were 19.5, 11.0 and 6.2 months respectively (P< 0.05).
Peritoneal seeding,serosal infiltration, lymph node metastasis are most important risk factors for synchronous hepatic metastasis from gastric cancer. Radical resection of gastric primary lesion and hepatic metastases can significantly prolong survival time.
分析影响胃癌同期肝转移的临床病理因素，并评估其手术疗效。
回顾性分析1994年8月至2004年2月间44例胃癌同期肝转移患者的临床资料，并与576例无肝转移的胃癌患者进行比较，以分析影响胃癌同期肝转移的临床病理因素。比较根治性切除、姑息性手术和探查性手术后的生存率。
单因素分析显示，腹水、盆腔及腹膜种植、浆膜侵犯、淋巴结转移、邻近器官受累、Borrmann分型、浸润深度与胃癌同期肝转移相关（P<0.01）。Logistic回归显示，腹膜种植（P=0.003，OR=1.629）、浆膜浸润（P=0.000，OR=3.000）、淋巴结转移（P=0.081，OR=1.689）是胃癌同期肝转移的独立危险因素。16例（36.4%）患者接受根治性切除，15例（34.1%）患者接受姑息性手术，13例（29.5%）患者接受探查性手术，中位生存时间分别为19.5、11.0和6.2个月（P<0.05）。
腹膜种植、浆膜浸润、淋巴结转移是胃癌同期肝转移最重要的危险因素。根治性切除胃原发灶和肝转移灶可显著延长生存时间。
