Cao Liang, Hu Xiang
Department of General Surgery, The First Affiliated Hospital, Dalian Medical University, Dalian 116011, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Feb;17(2):124-7.
To investigate the surgical results of hepatic resection for solitary metastasis form gastric cancer.
Clinical data of 53 patients who underwent simultaneous curative gastric and liver resection in our hospital from January 1998 to December 2012 were analyzed retrospectively. Univariate and multivariate analyses were performed to examine independent factors for survival.
In 53 patients, the accumulated 5-year survival rate after hepatic resection was 11.3%, 14.7% for solitary metastasis and 0 for multiple metastases. The statistically significant prognostic factors affecting 5-year survival rates were found to be serosal invasion (P=0.000), lymph node metastasis (P=0.000), the degree of radical resection (P=0.044), number of hepatic metastases (P=0.000), liver metastasis size (P=0.031). Multivariate Cox regression analysis showed that the serosal invasion (RR:3.355, P=0.012) and number of hepatic metastasis (RR:7.664, P=0.000) were independent prognostic factors in patients with liver metastasis from gastric cancer.
The prognosis of solitary metastasis from gastric cancer without serosal invasion can be improved through active radical resection based on suitable indications.
探讨胃癌单发转移灶肝切除的手术效果。
回顾性分析1998年1月至2012年12月在我院同时行胃癌根治术和肝切除术的53例患者的临床资料。进行单因素和多因素分析以检验生存的独立因素。
53例患者中，肝切除术后累积5年生存率为11.3%，单发转移者为14.7%，多发转移者为0。影响5年生存率的具有统计学意义的预后因素为浆膜侵犯（P=0.000）、淋巴结转移（P=0.000）、根治性切除程度（P=0.044）、肝转移灶数量（P=0.000）、肝转移灶大小（P=0.031）。多因素Cox回归分析显示，浆膜侵犯（RR：3.355，P=0.012）和肝转移灶数量（RR：7.664，P=0.000）是胃癌肝转移患者的独立预后因素。
对于无浆膜侵犯的胃癌单发转移，通过基于合适适应证的积极根治性切除可改善预后。
