Rafique M, Adachi W, Kajikawa S, Kobayashi M, Koike S, Kuroda T
Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Hepatogastroenterology. 1995 Sep-Oct;42(5):666-71.
BACKGROUND/AIMS: In order to improve the management of patients of gastric cancer with synchronous hepatic metastasis, their records were retrospectively studied.
From January 1981 to July 1993, 558 gastric cancer patients were admitted in our institute. Twenty-five with synchronous hepatic metastasis were used in this study. Among these 25 patients, six had hepatic metastasis alone and nineteen had some other additional noncurative prognostic factors. For the primary lesion, 12 patients received gastrectomy (total or distal subtotal) and 13 patients did not. For the hepatic metastasis, 12 patients had regional therapy (hepatectomy or hepatic arterial chemotherapy) and 13 had not. Both gastrectomy and regional therapy for hepatic metastasis were carried out in 6 patients who had hepatic metastasis alone.
Five year cumulative survival rate was 9%. Survival rate of patients with hepatic metastasis alone was significantly better than the patients with additional noncurative factors (p < 0.05). The two long term survivors in this study had no other noncurative factors except hepatic metastasis.
Neither gastrectomy nor regional therapy for hepatic metastasis had beneficial effects on the patients with additional noncurative factors. Gastrectomy and regional therapy for hepatic metastasis should be performed in patients without additional noncurative factors.
背景/目的：为了改善胃癌伴同步肝转移患者的管理，对他们的病历进行了回顾性研究。
1981年1月至1993年7月，我院收治了558例胃癌患者。本研究纳入了25例伴同步肝转移的患者。在这25例患者中，6例仅发生肝转移，19例有其他一些非治愈性预后因素。对于原发灶，12例患者接受了胃切除术（全胃或远端次全胃），13例未接受。对于肝转移灶，12例患者接受了局部治疗（肝切除术或肝动脉化疗），13例未接受。6例仅发生肝转移的患者同时接受了胃切除术和肝转移灶的局部治疗。
5年累积生存率为9%。仅发生肝转移患者的生存率明显高于有其他非治愈性因素的患者（p<0.05）。本研究中的两名长期存活者除肝转移外无其他非治愈性因素。
对于有其他非治愈性因素的患者，胃切除术和肝转移灶的局部治疗均无有益效果。胃切除术和肝转移灶的局部治疗应在无其他非治愈性因素的患者中进行。
