Hepatic resection improves the prognosis of gastric cancer liver metastasis patients with resected primary lesions.

IF 2.5 Q2 GASTROENTEROLOGY & HEPATOLOGY
Translational gastroenterology and hepatology Pub Date : 2025-06-03 eCollection Date: 2025-01-01 DOI:10.21037/tgh-24-126
Yun Feng, Mingzhu Huang, Bingran Yu, Chenchen Wang, Changming Zhou, Yilin Wang, Xiaodong Zhu, Lu Wang
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Abstract

Background: Although patients with gastric cancer liver metastases (GCLM) may achieve survival benefits after radical surgery, there is controversy regarding the surgical indications and choice of surgical methods. This study aims to investigate the impact of hepatic resection (HR) on the prognosis of patients with GCLM who have undergone radical resection of the primary tumor.

Methods: This study conducted a retrospective analysis of 120 patients with GCLM who have undergone resection of the primary tumor. The patients were divided into an HR group and a non-hepatic resection (NHR) group. Propensity score matching (PSM) was analyzed and patients' prognoses were followed up and compared.

Results: The PSM analysis included a total of 88 patients. The HR group had a median overall survival (OS) time of 35.0 months [95% confidence interval (CI): 30.7-39.3], with 1-, 2-, and 3-year survival rates of 88.0%, 81.5%, and 46.8% respectively. The NHR group had a median OS time of 16.0 months (95% CI: 10.5-21.5), with 1-, 2-, and 3-year survival rates of 56.8%, 30.8%, and 22.4% respectively. The median OS time was statistically different between the two groups. Extrahepatic metastasis (hazard ratio =2.777; 95% CI: 1.598-5.223; P=0.002) and HR (hazard ratio =0.154; 95% CI: 0.040-0.594; P=0.007) were significant factors for OS. In the HR group, laparoscopic surgery (P=0.004) and extrahepatic recurrence (P=0.008) were significant factors for intrahepatic recurrence-free survival (IHRFS).

Conclusions: HR can significantly improve the prognosis of GCLM with resected primary tumors. Laparoscopic surgery is preferred as the surgical approach. Patients with extrahepatic recurrence have a shorter IHRFS.

Abstract Image

Abstract Image

肝切除可改善原发病变切除的胃癌肝转移患者的预后。
背景:虽然胃癌肝转移(GCLM)患者在根治性手术后可以获得生存效益,但在手术指征和手术方法的选择上存在争议。本研究旨在探讨肝切除(HR)对原发肿瘤根治性切除的GCLM患者预后的影响。方法:本研究对120例行原发肿瘤切除术的GCLM患者进行回顾性分析。患者分为肝切除组和非肝切除组(NHR)。分析倾向评分匹配(PSM),并对患者预后进行随访和比较。结果:PSM分析共纳入88例患者。HR组的中位总生存期(OS)为35.0个月[95%可信区间(CI): 30.7-39.3], 1年、2年和3年生存率分别为88.0%、81.5%和46.8%。NHR组的中位OS时间为16.0个月(95% CI: 10.5-21.5), 1年、2年和3年生存率分别为56.8%、30.8%和22.4%。两组的中位OS时间有统计学差异。肝外转移(危险比=2.777;95% ci: 1.598-5.223;P=0.002)和HR(风险比=0.154;95% ci: 0.040-0.594;P=0.007)是影响OS的显著因素。在HR组中,腹腔镜手术(P=0.004)和肝外复发(P=0.008)是影响肝内无复发生存(IHRFS)的重要因素。结论:HR能显著改善GCLM原发肿瘤切除后的预后。腹腔镜手术是首选的手术方法。肝外复发患者的IHRFS较短。
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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