Department of Hepato-Biliary-Pancreatic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Department of Hepato-Biliary-Pancreatic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Asian J Surg. 2019 Jan;42(1):100-105. doi: 10.1016/j.asjsur.2017.09.005. Epub 2017 Dec 15.
Indications and efficacy of surgical treatment for liver metastases from gastric cancer (LMGCs) remain controversial. This retrospective study was designed to clarify the benefits of surgical treatment and identify prognostic factors.
Between December 1997 and December 2015, 34 consecutive patients underwent hepatic resection and surgical microwave ablation for synchronous or metachronous LMGCs at our institution. We analyzed their cumulative overall survival (OS) and recurrence-free survival (RFS) rates and clinical parameters to identify predictors of prognosis.
Of the 34 patients, 14 underwent hepatic resection, 13 underwent surgical microwave ablation, and 7 underwent hepatic resection combined with surgical microwave ablation. Their OS rates were 1-year: 84.4%, 3-year: 38.6%, and 5-year: 34.7%; and their RFS rates were 1-year: 38.5%, 3-year: 28.0%, and 5-year: 28.0%. OS did not significantly vary among the surgical procedures. In multivariable analysis, positive of both CEA and CA19-9 were independent predictors of poor survival (hazard ratio [HR] 4.51; P = 0.049) and early recurrence (HR 5.70; P = 0.047).
Both hepatic resection and surgical microwave ablation for LMGCs are effective and can improve survival in selected patients.
胃癌肝转移（LMGCs）的手术治疗适应证和疗效仍存在争议。本回顾性研究旨在阐明手术治疗的获益，并确定预后因素。
1997 年 12 月至 2015 年 12 月，本中心对 34 例同步或异时性 LMGC 患者行肝切除术和手术微波消融治疗。分析其累积总生存（OS）和无复发生存（RFS）率及临床参数，以确定预后预测因素。
34 例患者中，14 例行肝切除术，13 例行手术微波消融术，7 例行肝切除术联合手术微波消融术。其 1 年 OS 率为 84.4%，3 年 OS 率为 38.6%，5 年 OS 率为 34.7%；1 年 RFS 率为 38.5%，3 年 RFS 率为 28.0%，5 年 RFS 率为 28.0%。不同手术方式的 OS 无显著差异。多变量分析显示，CEA 和 CA19-9 均阳性是生存不良（HR 4.51；P=0.049）和早期复发（HR 5.70；P=0.047）的独立预测因素。
肝切除术和手术微波消融治疗 LMGCs 均有效，可改善部分患者的生存。
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