CAJ | 학술논문

目的系统评价胃癌原发灶联合肝脏切除治疗胃癌肝转移(GCLM)的临床价值及其与预后的相关性.方法检索2013年3月前在PubMed、Embase、Ovid、Springer-Link、Web of Science以及中国期刊全文数据库(CNKI)和中国生物医学文献数据库(CBMdisc)等已公开发表的胃癌联合肝脏切除治疗与单纯胃癌切除治疗进行比较的临床研究,通过入选标准和排出标准筛选文献,采用NOS表对文献进行质量评价,分析软件为Stata12.0.结果共有9篇文献符合入选标准,GCLM患者431例,其中胃癌联合肝脏切除治疗组189例,单纯胃癌切除组242例.9个研究分析结果显示,胃癌原发灶联合肝转移灶切除组患者术后生存明显优于单纯胃癌切除组(合并HR=0.50,95％CI:0.34～0.72,P=0.000),差异具有统计学意义.结论 GCLM患者在严格手术适应证的前提下进行胃癌原发灶联合肝脏切除术可以改善预后并提高生存率.
목적 계통평개위암원발조연합간장절제치료위암간전이(GCLM)적림상개치급기여예후적상관성.방법 검색2013년3월전재PubMed、Embase、Ovid、Springer-Link、Web of Science이급중국기간전문수거고(CNKI)화중국생물의학문헌수거고(CBMdisc)등이공개발표적위암연합간장절제치료여단순위암절제치료진행비교적림상연구,통과입선표준화배출표준사선문헌,채용NOS표대문헌진행질량평개,분석연건위Stata12.0.결과 공유9편문헌부합입선표준,GCLM환자431례,기중위암연합간장절제치료조189례,단순위암절제조242례.9개연구분석결과현시,위암원발조연합간전이조절제조환자술후생존명현우우단순위암절제조(합병HR=0.50,95％CI:0.34～0.72,P=0.000),차이구유통계학의의.결론 GCLM환자재엄격수술괄응증적전제하진행위암원발조연합간장절제술가이개선예후병제고생존솔.
Objective To assess the value of gastric and hepatic surgical treatment in gastric cancer patients with liver metastasis and its prognostic implication.Methods Literature search was performed in PubMed,Embase,Ovid,Springer-Link,Web of Science,CNKI,CBMdisc for clinical research published before March 2013 that compared gastrectomy alone to gastrectomy and hepatectomy.Inclusion criteria and exclusion criteria were performed.Quality assessment was based on NOS scale.Stata12.0 was used for statistical analysis.Results Nine studies including 431 patients were enrolled for analysis,among whom 189 underwent gastrectomy and hepatectomy and 242 underwent gastrectomy alone.Gastrectomy and hepatectomy group had better survival (HR =0.50,95％CI: 0.34-0.72,z=3.66,P=0.000).There was a subgroup analysis.Gastrectomy with hepatectomy group had significant advantages in prognosis in four foreign studies (HR=0.28,95％CI:0.18-0.44,z=5.77,P=0.000).There was no significant difference in five domestic studies (HR=0.74,95％CI:0.55-1.00,z=1.95,P=0.051).Conclusion Gastrectomy and hepatectomy in gastric cancer patients with liver metastasis improves long-term survival in select patients.