胃癌伴肝转移的治疗及预后分析

目的探讨胃癌伴肝转移的治疗方法及其疗效。方法回顾性分析我院1999年1月-2003年12月间经手术治疗的36例胃癌伴同时性肝转移患者的临床资料,其中原发灶及转移灶同步切除17例,对未切除的肝转移灶行无水酒精瘤体内注射＋门静脉化疗栓塞等局部治疗19例,并与1995年1月-1999年12月间收治条件类似的16例胃癌原发灶切除而对肝转移灶未治疗的患者进行比较。结果肝转移灶切除组的术后1年、3年生存率分别为65％、29％,肝转移灶局部治疗组术后1年、3年生存率分别为53％、26％,两组之间相比差异无统计学意义（P〉0．05）;肝转移灶未治疗组术后1年、3年生存率分别为19％、0,较肝转移灶局部治疗组1年、3年生存率低,两组之间差异有统计学意义（P〈0．01）。结论对胃癌肝转移灶无法切除者应积极行转移灶的局部治疗,可明显改善患者的预后。

The management of gastric cancer patients with synchronous hepatic metastasis

Objective To evaluate the management of synchronous liver metastasis in gastric cancer patients. Methods From January 1999 to October 2003,36 gastric cancer cases with synchronous hepatic metastasis were divided into two groups in which 17 cases received synchronous primary gastric cancer and metastasis resection and 19 cases received gastrectomy and postoperative regional therapies such as alcohol injection and intraportal vein chemoembolization. Data were compared with that of 16 clinicopathologically matched cases treated from January 1995 to October 1999 in which the metastasis was left untreated. Results The 1-,3-year survival rate of the group with hepatic resection for the metastasis was 65% and 29% , respectively, while for those receiving regional therapies was 53% and 26% , respectively, there was no significant difference between the two groups(P >0. 05). The 1-,3-year survival rate of the group in which the hepatic metastasis was left untreated was 19% and 0, respectively. The l-,3-year survival rate were statistically lower than those with the metastasis treated synchronously or postoperatively (P <0. 01). Conclusions Hepatic metastasis should be treated actively, and the prognosis can be improved.