胃癌肝转移的肝切除术适应证。

Indication for hepatic resection in the treatment of liver metastasis from gastric cancer.

机构信息

Department of Surgery, Gastroenterological Center, Yokohama City University, 4-57, Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.

出版信息

Anticancer Res. 2010 Jun;30(6):2367-76.

PMID:20651395

Abstract

BACKGROUND

The significance of hepatic resection for liver metastasis after gastric cancer is not well established. This study aimed to evaluate the effect of hepatic resection in such patients.

PATIENTS AND METHODS

A retrospective analysis was performed on the outcome of 63 patients with liver metastases without other non-curative factors of gastric cancer who underwent gastrectomy with or without hepatic resection.

RESULTS

Overall 1-, 3-, and 5-year survival rates were 61.9%, 17.2%, and 10.3%, respectively, with a median survival time of 16 months. This increased to 82.3%, 46.4%, and 37.1%, respectively, with a median survival time of 31.2 months in patients who underwent hepatic resection. Multivariate analysis showed that hepatic resection was an independent prognostic factor. Moreover, unilobar liver metastases significantly influenced favorable prognosis in patients receiving hepatic resection by univariate analysis.

CONCLUSION

In patients with liver metastases, hepatic resection may be a therapeutic option in the presence of unilobar liver metastases.

摘要

背景

胃癌术后肝转移行肝切除术的意义尚未明确。本研究旨在评估肝切除术对这类患者的疗效。

方法

回顾性分析 63 例胃癌术后无其他不可治愈因素且合并肝转移的患者的临床资料，其中行胃癌切除术联合肝切除术患者 33 例（联合组），行胃癌切除术未行肝切除术患者 30 例（未联合组）。

结果

联合组和未联合组患者的 1、3、5 年生存率分别为 61.9%、17.2%和 10.3%、53.3%、16.7%，中位生存时间分别为 16 个月、12 个月；联合组患者的 1、3、5 年生存率分别为 82.3%、46.4%和 37.1%，中位生存时间为 31.2 个月。多因素分析显示，肝切除术是影响患者预后的独立因素。单因素分析显示，肝转移灶位于单叶对行肝切除术患者的预后有显著影响。