【摘要】 目的:探讨胃癌同时性肝转移外科治疗方法及疗效。方法:回顾性分析2004年3月—2016年4月21例胃癌同时性肝转移患者行胃癌D2根治术的临床资料,根据有无行肝脏R0切除分为R0切除组(11例)和非R0切除组(10例),对两组临床病理特征和生存情况进行比较。结果:R0切除组1,2,3年生存率分别为54.5%,27.3%和27.3%;非R0切除组分别为48.0%,0和0(P=0.044)。中位生存期分别为16.2月和5.9月(P=0.008)。对R0切除组生存资料进行单因素分析发现Bormann分型(P=0.004)、区域淋巴结受累(P=0.010)与患者预后有关;多因素分析无明显独立预后因素,可能与Bormann分型与淋巴结受累存在交互作用(P=0.031)有关。结论:基于胃癌D2切除联合肝脏R0切除的多学科治疗可以提高疗效。更多还原

【Abstract】 Objective:To clarify the indications and efficacy after simultaneous surgical treatment in gastric cancer patients with synchronous hepatic metastases(GCHM). Methods:A total of21 GCHM patients who underwent D2 gastrectomy with R0 hepatic resection(11 cases) or non-R0 hepatic resection(10 cases) from March 2004 to April 2016 were analyzed retrospectively. The clini-copathological characteristics and survival were compared between the two groups. Results:Cumulative survival rate was improved in R0 hepatic resection group compared with non-R0 hepatic resection group:1-year(54.5% vs 48.0%), 2-year(27.3% vs 0%), and 5-year(27.3% vs 0%, P=0.044).The median survival time in R0 hepatic resection group and non-R0 hepatic resection group were 16.2 and 5.9 months(P=0.008). Univariate analysis revealed that Bormann’s classification(P=0.010) and state of regional lymph node(P=0.004) were significant predictive factors regarding cumulative survival rate. However, there was no significant prognostic factor(P=0.031) in multivariate analysis might partly owing to interaction among them and/or a small number of patients. Conclusion:Multidisciplinary treatments based on R0 hepatic resection combined with D2 gastrectomy could improve survival in selected GCHM patients.更多还原