Lin Chen, Wei-Song Shen, Ji-Yang Li, Jian-Xin Cui, Hong-Qing Xi, Bo Wei
Objective:
To assess the significance of gastric and hepatic surgical treatment in gastric cancer patients with liver metastases and its prognostic implication.
Methods:
Literature search was performed in PubMed, Web of Science, Medline, CNKI, CBMDisc for clinical research published before March 2013 that compared gastrectomy with hepatectomy with gastrectomy alone. Quality assessment was performed according to NOS scale. A certain method was used to extract data for Meta-analysis of prognosis and Stata12.0 was used for this meta-analysis.
Results:
9 studies including 431 patients were enrolled in this analysis. 189 patients with gastrectomy and hepatectomy were included, and the other group included 242 patients. The results showed that the former group had significant advantages in prognosis, HR=0.50 (95% CI: 0.34-0.72), z=3.66, P=0.001. A subgroup analysis was further performed because of a high heterogeneity. The meta-analysis of four foreign studies showed significant advantages in prognosis of the group with hepatectomy, HR=0.28 (95% CI: 0.18-0.44, z=5.77, P=0.001), but the five domestic studies showed a different result, HR=0.74 (95% CI: 0.55-1.00, z=1.95, P=0.051).
Conclusions:
Meta-analysis showed that gastrectomy with hepatectomy group has significant advantages in prognosis compared with gastrectomy alone group. Following a certain criteria for hepatic resection of liver metastases, gastrectomy with hepatectomy in gastric cancer patients with liver metastases improves long-term survival.
