Introduction: Recent studies have shown that radical gastrectomy with extended lymphadenectomy is feasible in gastric cancer patients with liver cirrhosis, but in those studies the main proportion was Child-Pugh class A patients. It is still difficult to choose reasonable surgical strategies for gastric cancer patients with cirrhosis, especially for Child-Pugh class B patients.
Methods: We reviewed the medical records of patients with liver cirrhosis who had undergone radical gastrectomy between January 2001 and December 2012. The clinical characteristics, postoperative complications, mortality and long-term outcomes in the 58 patients were investigated.
Results: Severe complications and postoperative mortality occurred more frequently in class B patients than in class A patients (P < 0.05). In patients with class A and B, the complications and mortality rate was 37.5% and 4.2% in D1 lymph node dissection group and 71.9% and 25% in D2 lymph node dissection group, respectively. Kaplan-Meier survival analysis showed longer survival for class A patients than for class B patients (P < 0.05). For class B patients with advanced gastric cancer, D2 lymph node dissection could not provide a longer survival than D1 lymph node dissection (P = 0.282).
Conclusion: Radical operation with D1 or D2 lymph node dissection can be tolerated in class A gastric cancer patients. D1 lymph node dissection is recommended in class B patients, and radical gastrectomy is very dangerous, even fatal for class C patients.
Keywords: Gastrectomy; Liver cirrhosis; Lymph node excision; Stomach neoplasms.
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