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胃转移性肿瘤的临床病理特征及治疗结果

Clinicopathological features and treatment outcomes of metastatic tumors in the stomach.

作者信息

Namikawa Tsutomu, Hanazaki Kazuhiro

机构信息

Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan,

出版信息

Surg Today. 2014 Aug;44(8):1392-9. doi: 10.1007/s00595-013-0671-9. Epub 2013 Jul 30.

Abstract

The metastasis of tumors to the stomach is rare, which underlies the clinical problems regarding their diagnosis and treatment. The present review summarizes the current knowledge regarding the clinicopathological characteristics, therapeutic strategies and outcomes for metastatic tumors in the stomach. The primary malignancies of the metastatic tumors in the stomach were most often breast cancers (27.9 %), followed by lung cancer (23.8 %), esophageal cancer (19.1 %), renal cell carcinoma (RCC; 7.6 %) and malignant melanoma (7.0 %). In cases of breast cancer and RCC as the primary malignancy, the median interval between the treatment of the primary tumor and diagnosis of the metastatic tumor in the stomach (IPM) was 50-78 and 75.6 months, respectively, highlighting the fact that the metastatic spread to the stomach may occur many years after the initial treatment of the cancer. In nine patients with metastatic gastric tumors arising from ovarian cancer, an endoscopic examination revealed submucosal tumors in six patients (66.7 %), with a median IPM of 30 months. Appropriate systemic treatment for these tumors is the preferred therapeutic strategy. Although solitary metachronous gastric metastasis several years after treatment of the primary tumor is an exceptionally rare event, surgical resection of metastatic gastric tumors may be recommended to control hemorrhaging or for selected tumors.

摘要

肿瘤转移至胃较为罕见,这构成了其诊断和治疗方面的临床难题。本综述总结了目前关于胃转移性肿瘤的临床病理特征、治疗策略及预后的相关知识。胃转移性肿瘤的原发恶性肿瘤最常见的是乳腺癌(27.9%),其次是肺癌(23.8%)、食管癌(19.1%)、肾细胞癌(RCC;7.6%)和恶性黑色素瘤(7.0%)。以乳腺癌和RCC作为原发恶性肿瘤时,原发肿瘤治疗与胃转移性肿瘤诊断之间的中位间隔时间(IPM)分别为50 - 78个月和75.6个月,这突出表明癌症初始治疗多年后可能发生转移至胃的情况。在9例源自卵巢癌的胃转移性肿瘤患者中,内镜检查显示6例患者(66.7%)存在黏膜下肿瘤,中位IPM为30个月。对这些肿瘤进行适当的全身治疗是首选的治疗策略。尽管在原发肿瘤治疗数年之后出现孤立性异时性胃转移是极为罕见的情况,但对于转移性胃肿瘤,为控制出血或针对特定肿瘤,可能建议进行手术切除。

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