Department of Surgery, Odawara Municipal Hospital, 46 Kuno, Odawara City, Kanagawa Prefecture, Japan.
Department of General Surgery, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba City, Chiba Prefecture, Japan.
World J Surg Oncol. 2020 Feb 24;18(1):41. doi: 10.1186/s12957-020-01816-9.
The indications for the surgical treatment of gastric cancer liver metastases (GCLMs) remain controversial. In addition, the outcome of surgery for the treatment of liver metastases of alpha-fetoprotein-producing gastric cancer (AFP-GC) has not yet been reported. We assessed the clinicopathologic features, including AFP-GC, and the surgical results of these patients.
This retrospective study analyzed 20 patients who underwent hepatectomy for GCLM at Odawara Municipal Hospital between April 2006 and January 2016.
The actuarial 1-, 3-, and 5-year overall survival (OS) rates after primary hepatectomy were 80.0%, 55.5%, and 31.7%, respectively, with a median OS of 42 months. Four patients survived for more than 5 years after their final hepatectomy procedures. A multivariate analysis showed multiple metastases in the liver, the elevated level of carbohydrate antigen 19-9 (CA19-9), and an age of less than 70 years to be independently associated with a poor prognosis in terms of OS. No significant differences were noted between the AFP-GC and AFP-negative GC groups.
Surgical treatment is therefore considered to be a feasible option for GCLM. The findings of the present study showed the number of metastatic liver tumors, the level of CA19-9, and the patient age to be prognostic indicators for the surgical treatment of GCLM.
胃癌肝转移（GCLM）的手术治疗适应证仍存在争议。此外，甲胎蛋白阳性胃癌（AFP-GC）肝转移手术治疗的结果尚未见报道。我们评估了这些患者的临床病理特征，包括 AFP-GC，并对其手术结果进行了分析。
本回顾性研究分析了 2006 年 4 月至 2016 年 1 月期间在小田原市医院接受肝切除术治疗 GCLM 的 20 例患者。
原发性肝切除术后的 1、3、5 年总生存率（OS）分别为 80.0%、55.5%和 31.7%，中位 OS 为 42 个月。4 例患者在最后一次肝切除术后存活超过 5 年。多因素分析显示，肝内多发转移、糖抗原 19-9（CA19-9）升高和年龄<70 岁与 OS 预后不良独立相关。AFP-GC 组与 AFP 阴性 GC 组之间无显著差异。
因此，手术治疗被认为是 GCLM 的一种可行选择。本研究结果表明，肝转移瘤的数量、CA19-9 水平和患者年龄是 GCLM 手术治疗的预后指标。
