胃癌肝转移的临床特点及治疗

Clinicopathological characteristics and treatment of stomach neoplasms with Hver metastasis

胃癌可通过血行转移、淋巴转移、原发性肿瘤的浆膜侵犯扩散到肝脏。胃癌肝转移的发生率仅次于腹膜转移，是胃癌远处转移的主要部位之一，是主要的肿瘤相关死亡原因，目前其治疗方案仍存较大争议。胃癌肝转移患者的最佳综合治疗策略应建立在患者的临床病理学特征基础之上，利用已有的循证医学证据，通过多学科讨论制定个体化方案。在更多的前瞻性研究结果发布之前，应采取以全身治疗为主的综合治疗，并慎重选择合适病例进行手术切除。

Gastric cancer can spread to the liver through hematogenous metastasis, lymphatic metasta- sis and serosal invasion of primary tumor. The occurrence of gastric cancer with liver metastasis is only second to the occurrence of peritoneal metastasis. Liver metastasis is one of the main distant metastasis of gastric canc- er, and is a major cause of cancer-related death. The treatment of gastric cancer with liver metastasis still remains controversial. The optimal treatment strategies should be based on the clinicopathological characteristics of each patients and evidence-based medicine, and the individualized plan should be set through muhidiscipli- nary team discussions. Before the more results of prospective studies released, muhidisciplinary treatment is the main method, and the appropriate patients should be cautiously choosed for surgery.