Department of Medical and Surgical Sciences and Translational Medicine, St. Andrea University Hospital, General Surgery Units, Sapienza University of Rome, Rome, Italy.
Department of Medical and Surgical Sciences and Translational Medicine, St. Andrea University Hospital, General Surgery Units, Sapienza University of Rome, Rome, Italy
Anticancer Res. 2022 Jan;42(1):25-33. doi: 10.21873/anticanres.15453.
Few data are available regarding metachronous liver metastases from gastric cancer. We aimed to identify data regarding the survival of these patients, considering the chosen treatment, with particular attention to the role of surgery.
A systematic review was carried out from 2000 to 2020. We chose articles reporting data from patients with metachronous liver metastases after curative gastrectomy. Data regarding 1-, 3- and 5-year overall survival were analyzed.
Survival was improved in patients eligible for surgery (absence of extrahepatic non-curative factors and feasible complete macroscopic removal of liver deposits, i.e., H1 and H2 liver involvement, metastases less than 5 cm in size) when curative liver resection was performed, with a median overall survival of 24 months (vs. 3.13 in patients treated with chemotherapy). N Status, extent and maximum size of liver metastases, and hepatic surgical treatment were identified as independent prognostic factors.
Selected patients with metachronous liver metastases from gastric cancer may benefit from multimodal 'aggressive' treatment. When hepatic involvement is limited (H1 and H2) and the size of metastases less than 5 cm, surgery was shown to increase survival.
关于胃癌的肝转移，目前仅有少量数据。本研究旨在探讨这些患者的生存数据，包括治疗方法，尤其关注手术的作用。
我们进行了一项系统性综述，检索范围为 2000 年至 2020 年。我们选择了报道根治性胃切除术后发生肝转移患者数据的文章。分析了 1 年、3 年和 5 年总生存率的数据。
对于有手术适应证的患者（无肝外非治愈因素和可行的肝内转移灶完全肉眼切除，即 H1 和 H2 肝累及，转移灶小于 5 cm），行根治性肝切除术可改善生存，中位总生存期为 24 个月（与接受化疗的患者 3.13 个月相比）。N 状态、肝转移的范围和最大直径，以及肝外科治疗被确定为独立的预后因素。
对于胃癌肝转移的患者，选择合适的患者进行多模式“积极”治疗可能获益。当肝累及局限（H1 和 H2）且转移灶小于 5 cm 时，手术可提高生存。
