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目的评价胃癌合并肝转移的外科治疗及对预后的影响。方法回顾总结48例胃癌肝转移的临床资料。结果对22例胃癌肝转移者仅行胃癌原发灶切除+术后全身化疗;对胃癌肝转移的孤立病灶行同步切除12例;未能切除肝转移灶者实施无水乙醇瘤体注射+门静脉埋泵化疗共14例。肝转移灶未治疗组术后1年、3年生存率为14%、0;肝转移灶切除术后组术后1年、3年生存率为58%、25%;肝转移灶局部治疗组术后1年、3年生存率分别为57%、21%。后两组之间相比,差异无统计学意义(P>0.05),但肝转移灶治疗组与未治疗组之间差异有统计学意义(P<0.01)。结论胃癌合并肝转移的病灶应实施积极的局部治疗,以改善患者的预后。
Objective To evaluate the surgical treatment of gastric cancer complicated with liver metastasis and prognosis. Methods The clinical data of 48 patients with liver metastasis from gastric cancer were reviewed. Results Twenty-two patients with liver metastases from gastric cancer underwent primary resection of gastric cancer and systemic chemotherapy after operation; 12 patients with isolated lesions of liver metastasis from gastric cancer underwent synchronous resection; 12 patients who failed to remove hepatic metastases were treated with ethanol injection and portal vein Buried pump chemotherapy in 14 cases. Liver metastases in untreated group 1 year after surgery, 3-year survival rate was 14%, 0; liver metastases resection group 1 year after surgery, 3-year survival rate was 58%, 25%; liver metastases local treatment group One year after surgery, the 3-year survival rates were 57% and 21%, respectively. The difference between the two groups was not statistically significant (P> 0.05), but the difference between the liver metastasis group and the untreated group was statistically significant (P <0.01). Conclusion Stomach cancer with liver metastases should be treated with active local treatment to improve the prognosis of patients.