摘要胃癌是中国人常见的恶性肿瘤,其生物学行为比较复杂.肝脏是胃癌患者转移的好发部位.与结直肠癌不同,胃癌肝转移常同时伴有远处淋巴转移、其他脏器转移和腹膜种植转移.针对胃癌仅伴有肝转移的病例,经过术前治疗可以获得手术切除病灶的机会,积极手术还是继续保守治疗争议较大.小样本的临床观察提示,手术可能使患者生存期延长.何种围手术期治疗方案可使更多的患者获得手术机会,目前尚无一致的认识.紫杉类、铂类和氟尿嘧啶类化疗药物以及抗人表皮生长因子受体-2的靶向治疗在晚期胃癌患者的治疗中均显示出较高的治疗反应率.这些方案在胃癌肝转移转化性治疗中的作用值得进一步分析和评价.
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abstractsGastric cancer remains one of the most common malignancies and leading causes of cancer death in China with a complex biological behavior.The incidence of liver metastasis from gastric cancer is particularly high.The indication of hepatectomy is controversial,however,surgery should be considered.How to choose the right regimen to obtain macroscopically complete resections represents a controversial subject.Newer generation cytotoxic agents such as docetaxel,S-1 and irinotecan as well as targeted therapy agent trastuzumab exhibit promising activity in gastric cancer.Further study and clinical trials are needed to confirm the benefits of systemic treatment in gastric cancer patients with liver metastasis.
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