胃癌肝转移的外科治疗

Surgical treatment of hepatic metastatic tumor from gastric cancer

目的探讨胃癌肝转移外科治疗的远期疗效。方法回顾性分析1993年1月至2001年10月间938例原发性胃癌患者中32例行胃癌肝转移灶切除者的临床资料。结果938例原发性胃癌患者中,异时性肝转移24例(2.6%),行肝转移灶切除14例(58.3%);同时性肝转移90例(9.6%),行肝转移灶切除18例(20.0%)。32例患者病理检查均证实为肝转移腺癌。术后1、3、5年生存率,异时性肝转移患者为73%、37%、25%;同时性肝转移患者为68%、24%、17%;两者差异无统计学意义(P>0.05)。结论孤立的同时及异时性肝转移患者经外科手术切除肝转移灶预后较好。

Objective To assess the long term efficacy of surgical treatment of hepatic metastases from gastric adenocarcinoma. Methods Clinical data of 938 cases with primary gastric cancer from January 1993 to October 2001 were analyzed retrospectively. Thirty two cases received resection of hepatic metastases from gastric adenocarcinoma. Results Metachronous hepatic metastasis occurred in 24 cases(2.6%),and 14 cases(58.3%) underwent resection of hepatic metastases,while synchronous hepatic metastasis occurred in 90 cases(9.6%) and 18 cases(20%) underwent resection of hepatic metastases. The 1 ,3 ,5 year survival rates of hepatic resection for metachronous hepatic metastases were 73%,37%,25%,respectively; while for synchronous hepatic metastases 68%,24%and 17%,respectively. There were no significant differences between the two groups(P >0.05). Conclusions Synchronous and metachronous hepatic metastases from gastric cancer should be treated by surgical resection to confirm a better prognosis.