Safety evaluation of curative gastrectomy for gastric cancer patients who underwent liver transplantation: a comparative study with conventional gastrectomy for gastric cancer patients

BackgroundWe aimed to examine the technical and oncological safety of curative gastrectomy for gastric cancer patients who underwent liver transplantation.MethodsIn this study, we compared the surgical and oncological outcomes of two groups. The first group consisted of 32 consecutive patients who underwent curative gastrectomy for gastric cancer after liver transplantation (LT), while the other group consisted of 127 patients who underwent conventional gastrectomy (CG). In addition, a subgroup analysis was performed to evaluate the impact of the background differences and the surgical outcomes on the involvement of a specialized liver transplant surgery team.ResultsThe mean operative time was significantly longer in the LT group (p < 0.05). Furthermore, there were more frequent cases of postoperative transfusion in the LT group compared to the CG group (p < 0.05). However, there were no significant differences in the overall complications between the groups (25.00 vs 23.62%, p = 0.874). The 5-year overall survival rates of the LT and CG groups were 76.7% and 90.1%, respectively (p < 0.05). The results of the subgroup analysis demonstrated no statistically significant difference in various early surgical outcomes, such as time to transfusion during surgery, first flatus, time to first soft diet, postoperative complications, hospital stay after surgery, and the number of harvested lymph nodes except for operation time.ConclusionsDespite one's medical history of undergoing LT, our study demonstrated that curative gastrectomy could be a surgically safe treatment for gastric cancer. However, further study should be conducted to identify the reason gastric cancer patients who underwent liver transplant surgery have lower overall survival rate.

Automated summary

This study compared the surgical and oncological outcomes between gastric cancer patients who underwent liver transplantation and curative gastrectomy, and those who only received curative gastrectomy. The results showed that there were no significant differences in overall complications between the two groups, but the liver transplantation group had longer operative time, higher transfusion frequency, and lower 5-year overall survival rate. This suggests that curative gastrectomy can be a safe treatment for gastric cancer, but further research is needed to identify the reasons for the lower survival rate in gastric cancer patients who underwent liver transplant surgery.