胃肠道间质瘤肝转移手术切除的疗效分析

目的探讨胃肠道间质瘤肝转移手术切除的疗效及价值。方法回顾性分析2004年3月至2007年5月57例CD117阳性胃肠道间质瘤肝转移中15例行肝转移灶切除的临床病理资料，并进行生存分析。结果15例胃肠道间质瘤肝转移患者中，同时性肝转移3例，异时性肝转移12例。其中肝转移灶行解剖型切除5例，不规则切除10例。无手术死亡发生。肝切除术后1年、2年、3年无病生存率分别为93．3％、53．3％、26．7％。中位无病生存期27个月。术后再次复发转移率86．7％，其中残余肝转移12例，肝外转移1例。结论局限的同时性或异时性肝转移患者经选择行转移灶切除是安全的，并可获得较长的生存。

Effect of Surgical treatment for gastrointestinal stromal tumors with liver metastasis

Objective To investigate the effect and value of surgical resection on liver metastasis from gastrointestinal stromal tumor（GIST）. Methods Clinicopathological data of 57 patients with gastrointestinal stromal tumor from March 2004 to May 2007 were analyzed retrospectively. And survival of fifteen patients who underwent surgical resection of liver metastatic GIST were analyzed. Results 15 cases of liver metastasis from gastrointestinal stromal tumor underwent surgical resection including synchronous liver metastasis in 3 cases and metachronous liver metastasis in 12 cases. Liver metastasis resection included regular resection in 5 cases and irregular resection in 10 cases. There was no in -hospital mortality in this series. The post -hepateetomy 1 - ,2 - and 3 - year survival rates were, 93. 3%, 53.3% and 26.7% respectively, with a median of 27 months. Recurrence after the initial hepateetomy was documented in 13 patients （86. 7% ）, including remnant liver metastasis in 12 cases and 1 in extra - liver metastasis. Conclusion Surgical resections for synchronous and metachtonous liver metastasis in selected patients with GIST is safe, and can achieve longer survival.