Radical gastrectomy with hepatoarterial catheter implantation for late-stage gastric cancer

AIM:To determine the optimal type of surgery for latestage gastric cancer with hepatic metastases.METHODS:We retrospectively analyzed 49 gastrectomies for late-stage gastric cancer conducted in the FirstHospital 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.