Liver resection for metastatic gastric cancer: Experience with 42 patients including eight long-term survivors
Liver resection for metastatic gastric cancer: Experience with 42 patients including eight long-term survivors
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DOI：
10.1093/jjco/hym113
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发表时间：
2007-11-01
影响因子：
2.4
通讯作者：
Yamaguchi, Toshiharu
中科院分区：
文献类型：
--
作者：
Koga, Rintaro;Yamamoto, Junji;Yamaguchi, Toshiharu
背景资料：肝切除术治疗胃转移瘤的适应证仍有争议，很少有研究报道手术治疗胃癌肝转移瘤的结果。本研究的目的是阐明手术切除术治疗胃癌肝转移的有效性。方法：对42例同时性（n = 20）或异时性（n = 22）胃肝转移患者的治疗结果进行回顾性分析。结果：肝切除术后1、3、5年生存率分别为76%、48%、42%，中位生存期为34个月。单因素分析显示单发和多发转移瘤的生存率差异有统计学意义（P = 0.03）。多因素分析显示，孤立性肝转移和原发性胃癌无浆膜浸润是有利的独立预后因素（分别为P = 0.005和P = 0.02）。所有8例在初次肝切除术后存活超过5年的患者均存在孤立性转移，其中6例原发性胃癌无浆膜浸润。没有多个转移性疾病的患者生存超过3 years.Conclusions：孤立性肝转移的患者是手术切除的良好候选人，而多个胃肝转移的患者应采用多种方法治疗。
Background: The indication for liver resection for gastric metastases remains controversial and few previous studies have reported the outcome of surgery in the treatment of liver metastases of gastric cancer. The aim of this study is to clarify the effectiveness of surgical resection for liver metastases arising from gastric cancer.Methods: A retrospective analysis was performed on the outcome of 42 consecutive patients with synchronous (n = 20) or metachronous (n = 22) gastric liver metastases that were curatively resected.Results: The overall 1, 3 and 5 year survival rates after hepatic resection were 76, 48 and 42%, respectively, and the median survival was 34 months. Univariate analysis revealed that survival significantly differed between cases of solitary and multiple metastases (P = 0.03). Multivariate analysis revealed that solitary liver metastasis and the absence of serosal invasion by primary gastric cancer were favorable independent prognostic factors (P = 0.005 and P = 0.02, respectively). All eight patients who survived for more than 5 years after initial hepatectomy had a solitary metastasis, and six of these had no serosal invasion by the primary gastric cancer. No patient with multiple metastatic diseases survived beyond 3 years.Conclusions: Patients with a solitary liver metastasis are good candidates for surgical resection, whereas those with multiple gastric liver metastases should be treated by multimodal approaches.