Gavriilidis Paschalis, Roberts Keith J, de'Angelis Nicola, Sutcliffe Robert P
Department of Hepato-Biliary-Pancreatic and Oesophago-Gastric Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London W12 0HS, UK.
Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Queen Elizabeth University Hospitals Birmingham, NHS Foundation Trust, B15 2TH, UK.
J Clin Med Res. 2019 Aug;11(8):600-608. doi: 10.14740/jocmr3925. Epub 2019 Jul 27.
Recent studies have demonstrated that hepatectomy in patients with synchronous hepatic gastric metastases may improve survival in certain patients. This study aimed to evaluate survival benefits of gastrectomy plus hepatectomy versus gastrectomy alone in patients with hepatic gastric metastases.
Studies were identified by a systematic search of Embase, PubMed, Cochrane Library, and Google Scholar databases. Traditional and cumulative meta-analyses were used to monitor the evidence over time.
Eleven studies which included 861 patients compared gastrectomy plus hepatic resection in 349 patients with gastrectomy alone in 512 patients. Overall significantly better survival rates of 1, 2, 3, and 5 years were demonstrated for patients who underwent gastrectomy plus hepatic resection compared to patients who under underwent gastrectomy alone ((hazard ratio (HR) = 0.52 (0.39, 0.69), P < 0.001), (HR = 0.85 (0.74, 0.97), P = 0.01), (HR = 0.80 (0.72, 0.90), P = 0.003), (HR = 0.83 (0.78, 0.90), P < 0.001), respectively).
Carefully selected patients with hepatic gastric metastases may benefit from hepatic resection.
近期研究表明，对于同时发生肝胃转移的患者，肝切除术可能会提高部分患者的生存率。本研究旨在评估肝胃转移患者行胃切除术加肝切除术与单纯胃切除术相比的生存获益情况。
通过系统检索Embase、PubMed、Cochrane图书馆和谷歌学术数据库来识别研究。采用传统和累积荟萃分析来长期监测证据。
11项研究共纳入861例患者，其中349例行胃切除术加肝切除术，512例仅行胃切除术。与单纯胃切除术患者相比，接受胃切除术加肝切除术的患者1年、2年、3年和5年的总体生存率显著更高（风险比分别为0.52（0.39，0.69），P < 0.001；0.85（0.74，0.97），P = 0.01；0.80（0.72，0.90），P = 0.003；0.83（0.78，0.90），P < 0.001）。
经过精心挑选的肝胃转移患者可能从肝切除术中获益。
