胃癌肝转移的手术疗效及影响因素

Surgical resection for gastric cancer patients with liver metastasis

目的探讨胃癌肝转移的手术疗效及其影响因素。方法回顾性分析2007年12月至2014年12月行手术切除的37例胃癌肝转移患者的临床病理资料，采用Cox比例风险模型分析影响患者预后的独立因素。结果全组患者1、3和5年生存率分别为91.4%、57.9%和22.0%，中位生存时间为37个月。单因素分析结果显示，淋巴结转移、肿瘤数目多发和术前未行化疗为患者术后预后不良的影响因素（均P〈0.05）。多因素分析结果显示，肝内转移灶数目和是否发生淋巴结转移为影响胃癌肝转移患者预后的独立因素（均P〈0.05）。结论对于胃癌肝转移患者，如果肝内转移灶为单发，行原发灶D2切除联合肝转移灶切除，患者仍有机会获得良好的长期生存。

Objective To explore the surgical results and clinicopathological features of gastric cancer patients with liver metastases. Methods The clinicopathological data and post-operative survival of 37 patients who underwent resection of liver metastasis from gastric cancer at our department from Dec. 2007 to Dec. 2014 were analyzed. Results The 1-, 3-, and 5-year overall survival rates after resection were 91.4%, 57.9%, and 22.0%, respectively, with a median survival of 37 months. Univariate analysis revealed that lymph node metastasis, multiple hepatic metastases and no preoperative chemotherapy are unfavorable prognostic factors for overall survival. Multivariate analysis identified that lymph node metastasis and number of liver metastasis are independent prognostic factors. Conclusions Gastric cancer patients with a solitary liver metastasis may be good candidates for gastric D2 resection combined with liver RO resection.