胃癌肝转移手术治疗远期疗效及预后因素的Meta分析  

Long-term efficacy and prognostic factors of surgical treatment for gastric carcinoma with liver metasta- ses： a Meta analysis

作　　者：朱婷[1] 王琦[1] 武希润[1] 刘春亮[1] 申慧琴[1] 

机构地区：[1]山西医科大学第二医院消化内科,太原030001

出　　处：《中华消化外科杂志》2016年第3期257-265,共9页Chinese Journal of Digestive Surgery

摘　　要：目的系统评价胃癌肝转移手术治疗的远期疗效及预后因素。方法以胃癌、胃肿瘤、肝转移、手术治疗、外科手术、肝切除术、生存率、预后因素、gastric cancer、gastric carcinoma、hepatic、resection、hepatic resection、hepatectomy、liver metastases、hepatic metastases、surgery、surgical、survival、prognostic factors等为检索词，检索中国期刊全文数据库、万方数据库、维普数据库、中国生物医学期刊文献数据库、PubMed、EMBASE、Cochrane Library、Medline、Springerlink、Wiley Online Library。检索时间为1995年1月至2015年8月。纳入胃癌肝转移行胃癌根治术联合肝转移癌切除术远期疗效及预后因素的相关研究，由2名研究者独立筛选文献和提取数据，并进行质量评价。计数资料采用相对危险度（relative ratio，RR）及95％可信区间（95％ confidence interval，95％CI）表示。单组率采用公式RR／（1＋RR）合并，相应的95％CI上限值采用公式上限值RR／（1＋上限值RR）转换，下限值采用公式下限值RR／（1＋下限值RR）转换。单组率的比较采用间接比较法，Z=单组率差/√各组率标准误平方之和。采用I^2对异质性进行分析。结果最终纳入符合标准的相关研究共18篇，均为横断面研究，累计样本量410例。Meta分析结果显示：（1）胃癌肝转移手术患者的3年总体生存率合并RR=0．47，95％CI：0．37～0．60；合并3年总体生存率为32．0％（95％CI：0．27～0．38）。（2）胃癌肝转移手术患者的5年总体生存率合并RR=0．35，95％CI：0．27～0．45；合并5年总体生存率为25．9％（95％CI：0．21～0．31）。（3）胃癌肝转移手术患者的总体复发率合并RR=2．95，95％CI：2．23～3．88；合并总体复发率为74．7％（95％CI：0．69—0．80）。（4）胃癌肝转移手术患者的剩余肝脏复发率合并RR=1．39，95％C1：0．91～2．15；合并剩余肝脏复发率为58Objective To evaluate systematically the long-term efficacy and prognostic factors of surgical treatment for gastric carcinoma with liver metastases （ GCLM ）. Methods Database including Chinese Journal Full Text Database, Wan Fang Database, VIP database, Chinese Database of Literature on Biomedicine, Pubmed, EMBASE, Cocbrane Library, Medline, Springerlink and Wiley Online Library were searched with ＂胃癌,胃肿瘤,肝转移,手术治疗,外科手术,肝切除术,生存率,预后因素,gastric cancer, gastric carcinoma,hepatic, resection, hepatic resection, hepatectomy, liver metastases, hepatic metastases, surgery, surgical, survival, prognostic factors＂. The time for retrieving was from January 1995 to August 2015. Literatures on long- term efficacy and prognostic factors of radical resection of gastric carcinoma combined with hepatectomy for GCLM were retrieved, and data were analyzed and evaluated by 2 independent researchers. The count data were presented by the relative risk （RR） and 95% confidence interval （95% CI）. The group rate was merged by the formula R_R/ （1 ＋RR） , corresponding 95% CI upper limit values were transferred by the formula RR/（ 1 ＋ upper limit value RR）, and the lower limit values were transferred by the formula RR/（ 1 ＋ lower limit value RR）. The comparison of group rates was done by indirect comparison, Z = difference between group rate/√^n∑（i=1）（standard error of group rate）^2.The heterogeneity was analyzed by 12. Results Eighteen literatures of cross-sectional studies were retrieved and the total sample size was 410 patients. The results of Meta analysis： （ 1 ） the summary RR of 3-year overall survival of surgical patients with GCLM was 0.47 （95% CI： 0. 37-0. 60） while the summary 3-year overall survival rate was 32.0% （ 95% CI： 0. 27 -0. 38 ）. （ 2 ） The summary RR of 5-year overall survival of surgical patients with GCLM was 0.35 （95% CI： 0. 27-0. 45 ） , summary RR of 5-year overall survival rate was 25.9% �

关 键 词：胃肿瘤 肝转移 外科手术 预后 META分析 

分 类 号：R735.2[医药卫生—肿瘤]