Evaluation for prognostic factors following surgical management of gastric cancer patients with hepatic cirrhosis

Abstract

Backgrounds: Prognosis following surgery of gastric cancer has markedly improved as a result of early diagnosis, advances in operative techniques and perioperative managements. However, gastrointestinal surgery in patients with hepatic cirrhosis has continued to be associated with a high operative morbidity and mortality. The purpose of this retrospective study is to evaluate the prognostic factors on postoperative morbidity and survival in gastric cancer patients with hepatic cirrhosis.

Methods: We analysed 24 gastric cancer patients with hepatic cirrhosis between November 1994 and October 1999 (19 patients with Child A, 5 patients with Child B) to evaluate postoperative complications and survivals.

Results: There were no significant differences in age, sex, stage, operative types, and range of dissection between Child A and B. Postoperative complications occurred more commonly in the patients with more severe hepatic cirrhosis (Child A 5/19, Child B 4/5, p<0.05). There was no significant difference in 5-year survival rates between patients with Child A and B hepatic cirrhosis. Only the stage of cancer was proved to be the most significant prognostic factor.

Conclusion: Patients with gastric cancer accompanied by hepatic cirrhosis can be successfully managed surgically on the basis of an appropriate preoperative assessment of hepatic conditions, proper selection of surgical procedures, and careful perioperative management.