Approximately 10–12% of patients with oesophageal or gastric cancer (OGC) present with oligometastatic disease at diagnosis. It remains unclear if there is a role for radical surgery in these patients. We aimed to assess the outcomes of OGC patients who underwent simultaneous treatment for the primary tumour and synchronous liver metastases. Patients with OGC who underwent surgical treatment between 2008 and 2020 for the primary tumour and up to five synchronous liver metastases aiming for complete tumour removal or ablation (i.e., no residual tumour) were identified from four institutional databases. The primary outcome was overall survival (OS), calculated with the Kaplan–Meier method. Secondary outcomes were disease-free survival and postoperative outcomes. Thirty-one patients were included, with complete follow-up data for 30 patients. Twenty-six patients (84%) received neoadjuvant therapy followed by response evaluation. Median OS was 21 months [IQR 9–36] with 2- and 5-year survival rates of 43% and 30%, respectively. While disease recurred in 80% of patients (20 of 25 patients) after radical resection, patients with a solitary liver metastasis had a median OS of 34 months. The number of liver metastases was a prognostic factor for OS (solitary metastasis aHR 0.330;p-value = 0.025). Thirty-day mortality was zero and complications occurred in 55% of patients. Long-term survival can be achieved in well-selected patients who undergo surgical resection of the primary tumour and local treatment of synchronous liver metastases. In particular, patients with a solitary liver metastasis seem to have a favourable prognosis.
约10%至12%的食管癌或胃癌患者在确诊时表现为寡转移性疾病。目前尚不清楚根治性手术在这些患者中是否具有治疗价值。本研究旨在评估同时接受原发肿瘤及同步肝转移灶治疗的食管癌或胃癌患者的临床结局。通过检索四家机构的数据库，筛选出2008年至2020年间接受手术治疗、且肝转移灶数量不超过5个（目标为完全切除或消融，即无肿瘤残留）的食管癌或胃癌患者。主要研究终点为总生存期，采用Kaplan-Meier法进行计算；次要研究终点包括无病生存期及术后结局。 共纳入31例患者，其中30例获得完整随访数据。26例患者（84%）接受了新辅助治疗并进行疗效评估。中位总生存期为21个月（四分位距9-36个月），2年及5年生存率分别为43%和30%。尽管根治性切除术后80%的患者（25例中的20例）出现疾病复发，但孤立性肝转移患者的中位总生存期达到34个月。肝转移灶数量是总生存期的预后因素（孤立性转移灶调整风险比为0.330，p=0.025）。术后30天死亡率为零，55%的患者出现并发症。 经过严格筛选的食管癌或胃癌患者，在接受原发肿瘤手术切除及同步肝转移灶局部治疗后，可获得长期生存。特别是孤立性肝转移患者，其预后更为良好。
肿瘤(癌症)患者之家