Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2754-2758
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2754
Radical gastrectomy with hepatoarterial catheter implantation for late-stage gastric cancer
Guo-Liang Yao, Yong-Gang Fan, Jing-Ming Zhai, Bao-Sai Lu, Kai-Long Liu
Guo-Liang Yao, Yong-Gang Fan, Jing-Ming Zhai, Department of General Surgery, The First Hospital of Henan University of Science and Technology, Luoyang 471000, Henan Province, China
Bao-Sai Lu, Kai-Long Liu, Department of Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Author contributions: Yao GL, Fan YG and Liu KL designed this research; Zhai JM and Lu BS performed this research; Fan YG, Lu BS and Liu KL analyzed data; Yao GL and Zhai JM wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kai-Long Liu, MD, Department of Surgery, The Second Hospital of Hebei Medical University, No. 215 West Heping Road, Shijiazhuang 050000, Hebei Province, China. ygl1982@sina.cn
Telephone: +86-379-69823229 Fax: +86-379-698236999
Received: September 4, 2014
Peer-review started: September 5, 2014
First decision: October 14, 2014
Revised: October 31, 2014
Accepted: December 5, 2014
Article in press: December 8, 2014
Published online: March 7, 2015
Abstract

AIM: To determine the optimal type of surgery for late-stage gastric cancer with hepatic metastases.

METHODS: We retrospectively analyzed 49 gastrectomies for late-stage gastric cancer conducted in the First Hospital Affiliated to Henan University of Science and Technology between September 2003 and September 2010. All gastrectomy operations were divided into two groups: radical resection (gastrectomy and simultaneous resection of hepatic metastases, n = 31), and palliative resection (gastrectomy without hepatic resection, n = 18). All 49 patients had chemotherapy catheter implantation in the hepatic artery via the gastroduodenal artery. Postoperative complications and cumulative survival rates of the two groups were compared and analyzed.

RESULTS: There was no significant difference in the number of perioperative complications between the radical and palliative resection groups (6 and 3 cases, respectively, P > 0.05). The incidence of long-term complications including ileus (3 in the radical resection and 2 in the palliative resection groups) and anastomosis (2 cases in each group) was not significantly different (P > 0.05). The cumulative survival rate was significantly lower in the palliative resection group (P < 0.05).

CONCLUSION: Radical gastrectomy with resection of hepatic metastases and hepatoarterial catheter implantation is the recommended surgery for late-stage gastric cancer patients with hepatic metastases.

Keywords: Gastric cancer, Hepatic metastases, Cumulative survival curve, Radical gastrectomy, Palliative gastrectomy

Core tip: Late-stage gastric cancer with liver metastases is difficult to treat surgically. We developed a new surgical procedure that included radical resection of gastric cancer and liver metastases, followed by implantation of a hepatoarterial catheter for postoperative infusion chemotherapy. Hepatoarterial infusion chemotherapy is a common procedure for liver cancer. Systemic and infusion chemotherapy resulted in a better cumulative survival rate in our study. We suggest that radical resection of gastric cancer and liver metastases with hepatoarterial catheter implantation is a better choice for late-stage gastric cancer.