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胃癌肝转移灶的肝切除术

Hepatic resection of liver metastases from gastric carcinoma.

作者信息

Miyazaki M, Itoh H, Nakagawa K, Ambiru S, Shimizu H, Togawa A, Shiobara M, Ohtsuka M, Sasada K, Shimizu Y, Yoshioka S, Nakajima N, Suwa T, Kimura F

机构信息

The First Department of Surgery, School of Medicine, Chiba University, Japan.

出版信息

Am J Gastroenterol. 1997 Mar;92(3):490-3.

PMID:9068476
Abstract

OBJECTIVES

Previous reports have indicated that results of the surgical resection of hepatic metastases from gastric carcinoma have been unsatisfactory. We therefore evaluated the results of aggressive surgical resection for hepatic metastases from gastric carcinoma, to identify candidates with a better likelihood of survival.

METHODS AND RESULTS

Twenty-one patients with synchronous or metachronous hepatic metastases from gastric carcinoma underwent hepatic resections. Five patients were still alive, without recurrence, at 10, 41, 46, 117, and 176 months after their hepatic resection. Sixteen patients died of recurrence 5-33 months (mean, 10 months) after hepatic resection. A significant difference in the number of node metastases (solitary or multiple) and in the tumor-free margin of the resection (< 10 mm or > 10 mm) was found between survivors and those who died.

CONCLUSION

Hepatic resection for hepatic metastases from gastric carcinoma may improve the prognosis in patients with a solitary metastasis if adequate tumor-free margins (> 10 mm) can be obtained.

摘要

目的

既往报告表明,胃癌肝转移灶的手术切除结果并不理想。因此,我们评估了胃癌肝转移灶积极手术切除的结果,以确定生存可能性更高的患者。

方法与结果

21例胃癌同步或异时性肝转移患者接受了肝切除术。5例患者在肝切除术后10、41、46、117和176个月时仍存活,无复发。16例患者在肝切除术后5 - 33个月(平均10个月)死于复发。在幸存者和死亡者之间,发现淋巴结转移数量(单发或多发)以及切除的切缘无瘤情况(< 10 mm或> 10 mm)存在显著差异。

结论

对于胃癌肝转移,如果能够获得足够的无瘤切缘(> 10 mm),肝切除术可能会改善单发转移患者的预后。

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