胃癌同时性肝转移手术治疗效果分析

Surgical treatment of liver metastasis of gastric cancer

目的评价胃癌同时性肝转移外科效果。方法回顾性分析2005~2017年间就诊于安徽医科大学第--附属医院行手术治疗的40例胃癌同时性肝转移患者,所有患者均行胃原发灶D2切除,根据肝脏转移灶是否行RO切除,分为A组肝脏转移灶切除(20例)与B组肝脏转移灶未切除(20例),比较两组临床资料及术后生存情况。结果两组术后并发症发生率未见明显差异(P=1.000),A组中位生存时间为11月(95%CI8.809~13.191)明显高于B组中位生存时间为5月(95%CI2.078~7.922),P=0.009。A组术后6月、1年、2年.3年生存率均好于B组,但在术后6月(P=0.006)、术后1年比较差距有统计意义(P=0.047),术后2年.3年生存率差异无统计学意义(P>0.05)。结论胃癌同时性肝转移患者,行胃癌D2切除联合肝脏转移灶RO切除,可延长患者生存期,且不增加术后并发症发生几率,具有良好的临床治疗效果。

Objective To evaluate the surgical ffect of gastric cancer with simultaneous liver metastasis.Method A retro-spective analysis was performed on 40 patients with gastric cancer with simultaneous liver metastasis who received surgical treatment in the First Afiliated Hospital of Anhui Medical University from 2005 to 2017.All patients accepted D2 resection of primary gastric lesion,according to whether liver metastases were resected by RO or not,the patients were divided into group A(20 cases)and group B(20 cases),and the clinical data and postoperative survival of the two groups were compared.Results Postoperative complication rates not seen difference between the two groups(P=1.000).Group A median survival time was significantly higher than group B(P=0.009).Postoperative survival rate of group A was higher than group B in 6-month,1-year,2-year and 3-year.However,there was a statistically significant difference in the 6-month,1-year postoperative survival rate(P<0.05),but no statstially significant diference in 2-year and 3-year(P>0.05).Conclusions For patients with gastric cancer with simultaneous liver metastasis,D2 resection combined with RO resection of liver metastasis can prolong the survival time of the patients without increasing the incidence of postoperative complications,showing a good clinical therapeutic effect.