胃癌患者同步肝转移的手术切除。一项倾向评分匹配研究。

Surgical resection of synchronous liver metastases in gastric cancer patients. A propensity score-matched study.

机构信息

Department of General and Abdominal Surgery, University Medical Centre Maribor, MariborSlovenia.

Faculty of Medicine, University of Maribor, MariborSlovenia.

出版信息

Radiol Oncol. 2020 Nov 10;55(1):57-65. doi: 10.2478/raon-2020-0067.

DOI:10.2478/raon-2020-0067

PMID:33885239

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7877268/

Abstract

BACKGROUND

The aim of the study was to determine the value of synchronous liver resection in patients with oligo-metastatic gastric cancer and the prognostic factors in these patients.

PATIENTS AND METHODS

We compared the results of 21 gastric patients with liver metastases and synchronous liver resection (LMR) to 21 propensity score-matched patients with gastric cancer and liver metastases in whom liver resection was not performed (LM0) and to a propensity score-matched control group of 21 patients without liver metastases and stage III and IV resectable gastric cancer (CG).

RESULTS

The overall 5-year survival of LMR, LM0 and CG were 14.3%, 0%, and 19%, respectively (p = 0.002). Five-year survival was 47.5% for well-differentiated tumour compared to 0% in patients with moderate or poor tumour differentiation ( = 0.006). In addition, patients with R0 resection and TNM stage N0-1 had a significantly better survival compared to patients with TNM N stage N2-3 (5-year survival: 60% for N0-1 . 7.7% for N2-3; = 0.007).

CONCLUSIONS

The results presented in the study support synchronous liver resections in gastric patients and provide additional criteria for patient selection.

摘要

背景

本研究旨在探讨寡转移型胃癌患者行同步肝切除术的价值及其预后因素。

患者与方法

我们将 21 例合并肝转移并行同步肝切除术（LMR）的胃癌患者与 21 例因各种原因未行肝切除术（LM0）的匹配患者及 21 例无肝转移且可切除的 III 期和 IV 期胃癌患者（CG）进行对比。

结果

LMR、LM0 和 CG 的总体 5 年生存率分别为 14.3%、0%和 19%（p=0.002）。高分化肿瘤患者的 5 年生存率为 47.5%，而中低分化肿瘤患者的生存率为 0%（ = 0.006）。此外，R0 切除且 TNM N 分期为 N0-1 的患者与 TNM N 分期为 N2-3 的患者相比，生存率显著提高（5 年生存率：N0-1 为 60%，N2-3 为 7.7%； = 0.007）。