Review of operative indication and prognosis in gastric cancer with hepatic cirrhosis.
Prognosis following surgery for gastric cancer has markedly improved as a result of early diagnosis, advances in operative techniques, and perioperative management. However, gastrointestinal surgery in patients with hepatic cirrhosis has continued to be associated with a high operative morbidity and mortality. On the basis of a detailed classification of the preoperative hepatic conditions into three risk groups, we have established a preoperative means of assessing surgical indication. Depending on the preoperative assessment, 40 gastric cancer patients with hepatic cirrhosis underwent surgical exploration. Thirty-seven patients (92.5%) received gastric resection, while 3 patients (7.5%) were non-resectable. Postoperative complications occurred in only 8 patients (20%), and no anastomotic leakage occurred; the overall operative mortality was zero. The five-year-survival rate following a curative resection, as calculated by Kaplan-Meier statistical analysis, was 51.4% (n = 30).
Takeda
J
J
First Department of Surgery, Kurume University School of Medicine, Japan.
Hashimoto
K
K
Tanaka
T
T
Koufuji
K
K
Kakegawa
T
T
D005260:Female; D005743:Gastrectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D011379:Prognosis; D012306:Risk; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods; D015996:Survival Rate