中文摘要：

目的：研究胃癌肝转移经肝动脉化疗栓塞联合射频消融治疗的临床意义。方法：选择胃癌肝转移灶小于4处，最大直径不超过4cm的患者23名。全组患者接受胃癌D2根治性切除及超声引导下射频消融治疗，其中15名患者术前接受了肝动脉化疗栓塞治疗。术后化疗采用以氟尿嘧啶及奥沙利铂为基础的方案。结果：本研究组未发生严重并发症，无病复发生存时间和总生存时间分别为366天和505天。5例患者获得无复发长期生存。多因素分析表明，N分期、转移癌的分布及是否接受肝动脉化疗栓塞治疗为独立预后因子。分层分析提示，术前肝动脉化疗栓塞治疗对多叶肝转移组疗效为优。结论：胃癌肝转移孤立或少数较小转移灶病例通过根治性手术、射频消融、肝动脉化疗栓塞术及术后化疗联合方案能够提高疗效，对部分患者可能获得长期生存的治疗成绩。

英文摘要：

Objective： To investigate the clinical significance ofradiofrequency thermal ablation （RFA） combined with transarterial chemoembolization （TACE） in hepatic metastasis of gastric cancer. Methods： This study enrolled 23 gastric cancer patients with hepatic metastasis of less than 4 lesions and diameter of no more than 4cm. All patients undertook radical gastrectomy with D2 lymphadenectomy, intraoperative RFA were undertaken under the ultrasonic guidance. Among the 23 patients, 15 received TACE preoperatively. Postopera- tive chemotherapy was performed in the majority of patients by fluorouracil and oxaliplatin based regimens. Results： This series of pa- tients had no severe complications. The recurrent free and overall survival was 366 days and 505 days respectively, 5 patients gained long term survival without recurrence. Multivariate analysis indicated that N staging, distribution of metastasis and TACE therapy were inde-pendent prognosis factor~ Stratification analysis indicated that preoperative TACE was significant in multi-lobes metastasis cases Conclusion： Sole or manipulus hepatic metastasis of stomach cancer could be effectively treated by multidisciplinary therapy such as radical gastrecto-my, RFA, TACE and postoperative chemotherapy. Some patients may get long survival time.