Feng Yun, Huang Mingzhu, Yu Bingran, Wang Chenchen, Zhou Changming, Wang Yilin, Zhu Xiaodong, Wang Lu
Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Gastrointestinal Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China.
Transl Gastroenterol Hepatol. 2025 Jun 3;10:48. doi: 10.21037/tgh-24-126. eCollection 2025.
Although patients with gastric cancer liver metastases (GCLM) may achieve survival benefits after radical surgery, there is controversy regarding the surgical indications and choice of surgical methods. This study aims to investigate the impact of hepatic resection (HR) on the prognosis of patients with GCLM who have undergone radical resection of the primary tumor.
This study conducted a retrospective analysis of 120 patients with GCLM who have undergone resection of the primary tumor. The patients were divided into an HR group and a non-hepatic resection (NHR) group. Propensity score matching (PSM) was analyzed and patients' prognoses were followed up and compared.
The PSM analysis included a total of 88 patients. The HR group had a median overall survival (OS) time of 35.0 months [95% confidence interval (CI): 30.7-39.3], with 1-, 2-, and 3-year survival rates of 88.0%, 81.5%, and 46.8% respectively. The NHR group had a median OS time of 16.0 months (95% CI: 10.5-21.5), with 1-, 2-, and 3-year survival rates of 56.8%, 30.8%, and 22.4% respectively. The median OS time was statistically different between the two groups. Extrahepatic metastasis (hazard ratio =2.777; 95% CI: 1.598-5.223; P=0.002) and HR (hazard ratio =0.154; 95% CI: 0.040-0.594; P=0.007) were significant factors for OS. In the HR group, laparoscopic surgery (P=0.004) and extrahepatic recurrence (P=0.008) were significant factors for intrahepatic recurrence-free survival (IHRFS).
HR can significantly improve the prognosis of GCLM with resected primary tumors. Laparoscopic surgery is preferred as the surgical approach. Patients with extrahepatic recurrence have a shorter IHRFS.
尽管胃癌肝转移（GCLM）患者在接受根治性手术后可能获得生存益处，但关于手术适应证和手术方法的选择仍存在争议。本研究旨在探讨肝切除（HR）对已接受原发性肿瘤根治性切除的GCLM患者预后的影响。
本研究对120例已接受原发性肿瘤切除的GCLM患者进行了回顾性分析。将患者分为HR组和非肝切除（NHR）组。进行倾向评分匹配（PSM）分析，并对患者的预后进行随访和比较。
PSM分析共纳入88例患者。HR组的中位总生存期（OS）为35.0个月[95%置信区间（CI）：30.7 - 39.3]，1年、2年和3年生存率分别为88.0%、81.5%和46.8%。NHR组的中位OS为16.0个月（95%CI：10.5 - 21.5），1年、2年和3年生存率分别为56.8%、30.8%和22.4%。两组的中位OS时间在统计学上存在差异。肝外转移（风险比 = 2.777；95%CI：1.598 - 5.223；P = 0.002）和HR（风险比 = 0.154；95%CI：0.040 - 0.594；P = 0.007）是OS的显著因素。在HR组中，腹腔镜手术（P = 0.004）和肝外复发（P = 0.008）是无肝内复发生存期（IHRFS）的显著因素。
HR可显著改善原发性肿瘤已切除的GCLM患者的预后。首选腹腔镜手术作为手术方式。发生肝外复发的患者IHRFS较短。
