胃癌肝转移肝切除的预后分析

Prognosis of hepatic resection for liver metastasis from gastric cancer

目的 分析胃癌肝转移后实施肝切除患者的预后因素。方法 对1996-2003年间实施肝切除的45例胃癌肝转移患者的临床资料进行回顾性研究，分析临床病理学指标与患者生存期之间的关系。结果 45例接受肝切除的患者有2例死于术后严重并发症。获得随访的39例患者的1，3，5年的总体生存率分别为54％，32％和21％。中位生存时间为29．5月，6例患者存活时间超过5年。胃周淋巴结转移、侵袭深度、辅助化疗、肝脏转移灶数目以及胃癌患者的组织学分级均与患者生存期之间存在不同程度的相关。但年龄、性别、肝脏转移灶的最大直径以及是否进行肝脏介入治疗与患者的生存期之间未见相关性。结论 无腹腔淋巴结广泛转移的胃癌肝转移后实施肝切除术可以延长患者的生存期。

Objective To evaluate the prognosis factors related to the hepatectomy for metastasis from gastric cancer. Methods The clinical and pathological data in 45 patients undergone hepatectomy for metastases from gastric cancer in Changzheng Hospital of Shanghai between 1996 and 2003 were retrospectively studied. The relationship between the liver and lymph node metastases, and patients＇ survival and recurrence were investigated. Results The 1,3 and 5-year survival rates of 39 cases in follow-up patients were 54%,32%, and 21%, respectively. The median survival time was 29.5 months, and 6 cases survived longer than 5 years. There was significant correlation among metastasiss of perigaastric lymph modes, depth of invasion and histopathologic grade of gastric cancer, adjuvant treatment, number of the metastases in liver and patients＇ survival, whereas no correlation was found among patients＇ age, sex, maximum diameter of the metastases, intervenfional therapy and patients＇ prognosis. Conclusion A patient with liver metastasis from gastric cancer has a greater chance of long＇term surviving if there is no lymph node metastasis at the primary site.