Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases
Survival benefit of combined curative resection of the stomach (D2 resection) and liver in gastric cancer patients with liver metastases
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DOI：
10.1093/annonc/mdn026
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发表时间：
2008-06-01
影响因子：
50.5
通讯作者：
Chung, H. C.
中科院分区：
文献类型：
--
作者：
Cheon, S. H.;Rha, S. Y.;Chung, H. C.
背景：外科手术切除胃癌肝转移的益处尚未完全确定。方法：回顾1995-2005年延世大学卫生系统收治的10259例胃腺癌患者中，58例单纯胃转移癌患者的临床资料。结果：41例有疗效的肝切除患者的1、3、5年生存率分别为75.3%、31.7%、20.8%，其中3例存活7年。41例中，22例完全切除，19例姑息性切除。根治性和姑息性切除相比，根治性切除和姑息性切除的存活率没有差别。肝转移的个数(单发或多发)是影响生存的一个微乎其微的重要因素。结论：如果胃腺癌肝转移在仔细的术前分期后完全切除是可行的，那么手术治疗是合理的，即使实际上没有完全切除。对于有肝转移的胃癌患者，应考虑行肝切除术。
Background: The benefit of surgical resection of liver metastases from gastric cancer has not been well established. The aim of this study was to evaluate the rationale for hepatic resection in patients with hepatic metastases from gastric cancer.Methods: Among 10 259 patients diagnosed with gastric adenocarcinoma in the Yonsei University Health System from 1995 to 2005, we reviewed the records of 58 patients with liver-only metastases from gastric cancer who underwent gastric resection regardless of hepatic surgery.Results: The overall 1-year, 3-year, and 5-year survival rates of 41 patients who underwent hepatic resection with curative intent were 75.3%, 31.7%, and 20.8%, respectively, and three patients survived > 7 years. Of the 41 patients, 22 had complete resection and 19 had palliative resection. Between the curative and palliative resections, survival rates after curative intent were not different. The number of liver metastasis (solitary or multiple) was a marginally significant prognostic factor for survival.Conclusions: Surgery for liver metastases arising from gastric adenocarcinoma is reasonable if complete resection seems feasible after careful preoperative staging, even if complete resection is not actually achieved. Hepatic resection should be considered as an option for gastric cancer patients with hepatic metastases.