Abstract：
Chemotherapy is the mainstay treatment for liver metastasis from gastric cancer. However, some retrospective studies and meta-analyses have indicated the efficacy of hepatectomy, which is an aggressive treatment option. However, the optimal selection criteria for hepatectomy and the role of perioperative chemotherapy remain unclear. Therefore, a meta-analysis of studies on hepatectomy was performed to assess the impact of various factors on overall survival (OS). A systematic review was conducted in accordance with the PRISMA criteria using studies published until 2022. The primary outcome was the hazard ratio (HR) for OS. Comparisons were made between hepatectomy and nonhepatectomy, solitary and multiple metastases, synchronous and metachronous metastases, treatment with and without neoadjuvant chemotherapy, and treatment with and without adjuvant chemotherapy. A total of 50 studies involving 1966 patients who underwent hepatectomy were included in the analysis. The meta-analysis showed a 5-year OS rate of 25 %. A meta-analysis comparing hepatectomy with nonhepatectomy showed an HR of 0.2 for hepatectomy. A meta-analysis comparing solitary and multiple metastases showed a trend toward better OS in patients with solitary metastases (odds ratio [OR]: 0.35). A meta-analysis comparing synchronous and metachronous metastases showed favorable OS for patients with metachronous metastases (OR: 0.66). A meta-analysis comparing neoadjuvant chemotherapy with no neoadjuvant chemotherapy showed no difference in OS. In contrast, a meta-analysis comparing adjuvant chemotherapy with no adjuvant chemotherapy showed better OS for adjuvant chemotherapy (OR: 0.39). This retrospective study indicates that hepatectomy may benefit patients with liver metastases from gastric cancer, particularly those with solitary and metachronous metastases.
摘要：
化疗是胃癌肝转移的主要治疗手段。然而,一些回顾性研究和荟萃分析表明肝切除术的疗效，这是一种积极的治疗选择。然而,肝切除术的最佳选择标准和围手术期化疗的作用尚不清楚.因此,我们对肝切除术研究进行了荟萃分析,以评估各种因素对总生存期(OS)的影响.根据PRISMA标准，使用2022年之前发表的研究进行了系统评价。主要结果是OS的风险比（HR）。比较肝切除术和非肝切除术，孤立性和多发性转移，同步和异时转移，有或没有新辅助化疗的治疗，以及有和没有辅助化疗的治疗。共有50项研究包括1966例接受肝切除术的患者。荟萃分析显示，5年OS率为25％。比较肝切除术与非肝切除术的荟萃分析显示，肝切除术的HR为0.2。一项比较孤立性和多发性转移的荟萃分析显示，孤立性转移患者的OS趋势更好（比值比[OR]：0.35）。一项比较同步和异时转移的荟萃分析显示，异时转移患者的OS较好（OR：0.66）。一项比较新辅助化疗和没有新辅助化疗的荟萃分析显示OS没有差异。相比之下,一项比较辅助化疗和无辅助化疗的荟萃分析显示,辅助化疗的OS较好(OR:0.39).这项回顾性研究表明，肝切除术可能使胃癌肝转移患者受益。特别是那些有单独和异时转移的。
