Clinical Study On Surgical Treatment Of Simultaneous Liver Metastasis Of Gastric Cancer

Objective : To investigate the feasibility and safety of surgical resection and postoperative survival in patients with simultaneous liver metastasis of gastric cancer,and to provide corresponding strategies for clinical diagnosis and treatment.Method: A retrospective analysis was performed on 40 patients with gastric cancer with simultaneous liver metastasis who received surgical treatment in the First Affiliated Hospital of Anhui Medical University from 2005 to 2017.All patients underwent D2 resection of primary gastric lesions,and were divided into group A and group B according to whether liver metastases underwent R0 resection or not.Group A underwent R0 resection of liver metastases(20 cases)and group B underwent non-R0 resection of liver metastases(20 cases),and the clinical data and postoperative survival of the two groups were compared.Statistical methods were used to calculate the survival rate of 6 months,1,2,and 3 years after surgery,compared according to the incidence of postoperative complications.The clinical treatment effect of the two groups was compared and the corresponding results were obtained.Results:There was no significant difference in clinical data between the two groups.The median survival time of group A was 11 months(95% confidence interval8.809-13.191),which was significantly longer than that of group B(95% confidence interval 2.078-7.922),P=0.009,and the difference was statistically significant.In group A,the survival rates at 6 months,1 year,2 years and 3 years after surgery were 90%,50%,15%,15%,respectively.In group A,the survival rates at 6 months,1 year,2 years and 3 years after surgery were 50%,20%,5%,0%,respectively.However,there was a statistically significant difference between the two groups in survival rate at 6 months,1year after surgery,P values were 0.006 0.047,respectively.Although there were differences in the 2-year and 3-year survival rates between group A and group B,there was no statistical significance,and the P values were 0.292 0.084,respectively.There was no statistically significant difference in operative time,intraoperative blood loss,postoperative complications and Postoperative recurrence between the two groups.P value was 0.525,0.429,1.00,0.342,respectively.Conclusions: For patients with simultaneous liver metastasis of gastric cancer,D2 resection combined with R0 resection of liver metastasis can prolong the survival time of patients compared with D2 resection alone.And it doesn’t increase the amount of blood that’s lost during the operation.And it doesn’t add extra time to the operation.There was no significant difference in the incidence of postoperative complications.It is suggested that it has good clinical therapeutic effect.Radical gastrectomy combined with R0 resection of liver metastases is feasible and safe.After preoperative evaluation of these patients,combined resection should be performed as far as possible if the criteria for radical resection are met.