Abstract

Objective

The prognosis of patients with liver metastases from gastric cancer is determined using tumor size and number of metastases; this is similar to the factors used for the prediction of liver metastases from colorectal cancer. The relationship between the degree of liver metastasis from gastric cancer and prognosis with reference to the classification of liver metastasis from colorectal cancer was investigated.

Methods

This was a multi-institutional historical cohort study. Among patients with stage IV gastric cancer, who visited the cancer hospitals in Fukushima Prefecture, Japan, between 2008 and 2015, those with simultaneous liver metastasis were included. Abdominal pretreatment computed tomography images were reviewed and classified into H1 (four or less liver metastases with a maximum diameter of ≤5 cm); H2 (other than H1 and H3) or H3 (five or more liver metastases with a maximum diameter of ≥5 cm). The hazard ratio for overall survival according to the H grade (H1, H2 and H3) was calculated using the Cox proportional hazards model.

Results

A total of 412 patients were analyzed. Patients with H1, H2 and H3 grades were 118, 162 and 141, respectively, and their median survival time was 10.2, 5.7 and 3.1 months, respectively (log-rank P < 0.001). The adjusted hazard ratio for overall survival was H1: H2: H3 = reference: 1.39 (95% confidence interval: 1.04–1.85): 1.69 (95% confidence interval: 1.27–2.27).

Conclusions

The grading system proposed in this study was a simple and easy-to-use prognosis prediction index for patients with liver metastasis from gastric cancer.

中文翻译：

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预测胃癌肝转移预后的分级系统

摘要

客观的

胃癌肝转移患者的预后取决于肿瘤大小和转移数量；这类似于用于预测结直肠癌肝转移的因素。参照结直肠癌肝转移分类探讨胃癌肝转移程度与预后的关系。

方法

这是一项多机构历史队列研究。在 2008 年至 2015 年间就诊于日本福岛县癌症医院的 IV 期胃癌患者中，包括同时发生肝转移的患者。回顾腹部预处理计算机断层扫描图像并分类为H1（4个或更少的肝转移，最大直径≤5 cm）；H2（H1和H3除外）或H3（5个或更多肝转移，最大直径≥5厘米）。使用 Cox 比例风险模型计算根据 H 级（H1、H2 和 H3）的总生存风险比。

结果

共分析了 412 名患者。H1、H2 和 H3 级患者分别为 118、162 和 141，中位生存时间分别为 10.2、5.7 和 3.1 个月（对数秩P  < 0.001）。调整后的总生存期风险比为 H1: H2: H3 = 参考值：1.39（95% 置信区间：1.04-1.85）：1.69（95% 置信区间：1.27-2.27）。

结论

本研究提出的分级系统是一种简单易用的胃癌肝转移患者预后预测指标。