Surgical treatment for liver metastasis from gastric cancer: A systematic review and meta-analysis of long-term outcomes and prognostic factors

IF 3.5 2区 医学 Q2 ONCOLOGY
Ejso Pub Date : 2024-08-06 DOI:10.1016/j.ejso.2024.108582
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引用次数: 0

Abstract

Chemotherapy is the mainstay treatment for liver metastasis from gastric cancer. However, some retrospective studies and meta-analyses have indicated the efficacy of hepatectomy, which is an aggressive treatment option. However, the optimal selection criteria for hepatectomy and the role of perioperative chemotherapy remain unclear. Therefore, a meta-analysis of studies on hepatectomy was performed to assess the impact of various factors on overall survival (OS). A systematic review was conducted in accordance with the PRISMA criteria using studies published until 2022. The primary outcome was the hazard ratio (HR) for OS. Comparisons were made between hepatectomy and nonhepatectomy, solitary and multiple metastases, synchronous and metachronous metastases, treatment with and without neoadjuvant chemotherapy, and treatment with and without adjuvant chemotherapy. A total of 50 studies involving 1966 patients who underwent hepatectomy were included in the analysis. The meta-analysis showed a 5-year OS rate of 25 %. A meta-analysis comparing hepatectomy with nonhepatectomy showed an HR of 0.2 for hepatectomy. A meta-analysis comparing solitary and multiple metastases showed a trend toward better OS in patients with solitary metastases (odds ratio [OR]: 0.35). A meta-analysis comparing synchronous and metachronous metastases showed favorable OS for patients with metachronous metastases (OR: 0.66). A meta-analysis comparing neoadjuvant chemotherapy with no neoadjuvant chemotherapy showed no difference in OS. In contrast, a meta-analysis comparing adjuvant chemotherapy with no adjuvant chemotherapy showed better OS for adjuvant chemotherapy (OR: 0.39). This retrospective study indicates that hepatectomy may benefit patients with liver metastases from gastric cancer, particularly those with solitary and metachronous metastases.

胃癌肝转移的手术治疗:长期疗效和预后因素的系统回顾和荟萃分析。
化疗是治疗胃癌肝转移的主要方法。然而,一些回顾性研究和荟萃分析表明,肝切除术是一种积极的治疗方案,具有一定疗效。然而,肝切除术的最佳选择标准和围手术期化疗的作用仍不明确。因此,我们对有关肝切除术的研究进行了荟萃分析,以评估各种因素对总生存率(OS)的影响。根据PRISMA标准,对2022年前发表的研究进行了系统性回顾。主要结果是OS的危险比(HR)。比较了肝切除术和非肝切除术、单发转移灶和多发转移灶、同步转移灶和间期转移灶、新辅助化疗和非新辅助化疗以及辅助化疗和非辅助化疗。共有 50 项研究被纳入分析,涉及 1966 名接受肝切除术的患者。荟萃分析结果显示,5 年的 OS 率为 25%。一项比较肝切除术与非肝切除术的荟萃分析显示,肝切除术的 HR 为 0.2。一项比较单发转移灶和多发转移灶的荟萃分析显示,单发转移灶患者的 OS 有改善的趋势(几率比 [OR]:0.35)。一项比较同步转移灶和间质转移灶的荟萃分析显示,间质转移灶患者的OS较好(OR:0.66)。一项比较新辅助化疗与不进行新辅助化疗的荟萃分析显示,两者的OS没有差异。相反,一项比较辅助化疗与不进行辅助化疗的荟萃分析表明,辅助化疗的 OS 更好(OR:0.39)。这项回顾性研究表明,肝切除术可使胃癌肝转移患者获益,尤其是那些单发转移和远处转移的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ejso
Ejso 医学-外科
CiteScore
6.40
自引率
2.60%
发文量
1148
审稿时长
41 days
期刊介绍: JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.
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