Aizawa Masaki, Nashimoto Atsushi, Yabusaki Hiroshi, Nakagawa Satoru, Matsuki Atsushi
Hepatogastroenterology. 2014 Jul-Aug;61(133):1439-45.
BACKGROUND/AIMS: The aim of this study was to evaluate the benefit of resection for liver metastasis from gastric cancer. METHODOLOGY: Consecutive 74 patients of gastric cancer who undergone the gastrectomy for primary gastric cancer and simultaneous hepatic resection for synchronous liver metastasis were enrolled. The clinicopathological factors were retrospectively compared to the prognosis. RESULTS: The median survival time and 5-year overall survival rate in 53 patients who accomplished microscopically negative margin resection was 27.4 months and 18.6%, respectively. In the multivariate survival analysis, the number of liver metastasis was identified as an independent prognostic factor (HR;2.232, 95%CI;1.036-4.808, p=0.04). When the patients undergone curative resection were subdivided into solitary and multiple liver metastasis, the median survival time and 5-year overall survival rate in a subgroup with solitary liver metastasis was 24.2 months and 27.2%, which was superior to the corresponding values of 12.6 months and 5.5% in another group with multiple liver metastasis (p=0.02). CONCLUSIONS: The resection for liver metastasis might offer a chance for long-term survival in a carefully selected group of patients. The number of liver metastasis was a reliable criterion to discriminate the subgroup of patients who are most likely to benefit from hepatic resection.
背景/目的:本研究旨在评估胃癌肝转移行切除术的益处。 方法:连续纳入74例因原发性胃癌接受胃切除术并同时因同步肝转移接受肝切除术的胃癌患者。回顾性比较临床病理因素与预后。 结果:53例实现显微镜下切缘阴性切除的患者,中位生存时间和5年总生存率分别为27.4个月和18.6%。在多因素生存分析中,肝转移灶数量被确定为独立预后因素(HR;2.232,95%CI;1.036 - 4.808,p = 0.04)。当将接受根治性切除的患者细分为孤立性和多发性肝转移时,孤立性肝转移亚组的中位生存时间和5年总生存率分别为24.2个月和27.2%,优于多发性肝转移另一组的相应值12.6个月和5.5%(p = 0.02)。 结论:肝转移灶切除术可能为精心挑选的患者群体提供长期生存机会。肝转移灶数量是区分最有可能从肝切除术中获益的患者亚组的可靠标准。
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