Oncology
doi: 10.25005/2074-0581-2018-20-4-383-388
PALLIATIVE-CURATIVE SURGICAL INTERVENTIONS IN GASTRIC CANCER PATIENTS WITH LIVER METASTASES
1Department of Oncology and Radiology, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Republican Cancer Research Center, Dushanbe, Republic of Tajikistan
3Department of Oncology, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan
Objective: To assess the effectiveness of relatively curative surgical interventions in the treatment of patients with gastric cancer with metastases to the liver and to show the role of active surgical tactics in improving the quality of life of patients.
Methods: The study included 28 patients with gastric cancer with metastases to the liver. Patients with type I and type II Borrmann’s tumor growth (17 (85.7%) patients) were prevalent. It was found that in the predominant majority of patients had lesions of regional lymph nodes (91.6%). Detection of ultrasound and CT studies of enlarged retroperitoneal lymph nodes, lymph nodes of the aortocaval space, as well as massive invasion of the serous cover of the stomach with the extra organ component detected by laparoscopy, is a contraindication for performing simultaneous operations on the stomach and liver. In 14 (50%) patients,surgical interventions were carried out against the background of a complicated clinical course of gastric cancer: in the presence of pylorostenosis in 9 (32%) cases and torpid (sluggish) bleeding in 5 (17.85%) cases.
Results: Analyzing the primary tumour and metastatic hearth in the liver, we came to the conclusion that gastric cancer with gastric metastases in the liver should be resected in cases of highly or moderately differentiated adenocarcinoma that has exophytic or mixed forms of growth, preferably with the intactness of the serous cover of the stomach. Practically in half of the patients in our series, the metastasis in regional lymph nodes are revealed,however, only in two, the defeat of lymph nodes of the second – order was diagnosed. Thus, “resectable” liver metastases can occur even at the N0 stages. In the studied group, patients with type I and II Borrmann’s prevailed with type I and II, most of them showed the intestinal histological type of a tumour.
Conclusion: Liver resection for gastric cancer metastases should be performed under the following conditions: the absence of other distant metastases (peritoneum, non-regional lymph nodes, etc.); performing “radial” gastrectomy with D2-D3 lymphadenectomy; the possibility of carrying out macroscopic radical resection of the liver; functional portability of the operation; physiological operability.
Keywords: Gastric cancer with liver metastases, palliative operations, indications, prognosis.
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Authors' information:
Yuldoshev Ravshan Zokhidovich,
Doctor of Medical Sciences, Head of the Department of Oncology and Radiology, Avicenna Tajik State Medical University
Zikiryakhodzhaev Dilshod Zukirovich,
Doctor of Medical Sciences, Full Professor, Chief Consultant of Surgical Departments, Republican Cancer Research Center
Rakhmatov Mukhammad Temurovich,
Candidate of Medical Sciences, Associate Professor of the Department of Oncology and Radiology, Avicenna Tajik State Medical University
Dilshodov Sukhrob Akhmedovich,
Cancer Surgeon of the Thoraco- Abdominal Department, Republican Cancer Research Center
Azatulloev Yodgor Imomrizoevich,
Assistant of the Department of Oncology, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan
Khodzhamkulov Ashurali Akramovich,
Head of the Thoraco-Abdominal Department, Republican Cancer Research Center
Conflicts of interest: No conflict
Address for correspondence:
Yuldoshev Ravshan Zokhidovich
Doctor of Medical Sciences, Head of the Department of Oncology and Radiology, Avicenna Tajik State Medical University
734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139
Tel.: +992 (918) 679399
E-mail: uravshan@mail.ru
Materials on the topic:
- MODERN VIEW ON REHABILITATION OF CANCER PATIENTS
- COMPLEX DIAGNOSIS OF CERVICAL INTRAEPITHELIAL NEOPLASIA IN THE REPUBLIC OF TAJIKISTAN
- MODERN METHODS OF LOCAL TREATMENT OF PATIENTS WITH UVEAL MELANOMA WITH LIVER METASTASES
- FIRST RESULTS OF TREATMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIA IN THE REPUBLIC OF TAJIKISTAN
- INFLUENCE OF PLASTIC AND RECONSTRUCTIVE SURGERY ON THE QUALITY OF LIFE OF PATIENTS WITH LOCALLY ADVANCED HEAD AND NECK CANCER
- OUR EXPERIENCE OF IMMUNOHISTOCHEMICAL ASSAY IN BREAST CANCER
- EXPERIENCE OF MULTIVISCERAL RESECTIONS IN LOCALLY ADVANCED AND PRIMARY-MULTIPLE RECTAL CANCER
- COMBINED TREATMENT OF PATIENTS WITH NON-SMALL CELL LUNG CANCER WITH PERSONALIZED PRESCRIPTION OF ADJUVANT CHEMOTHERAPY
- MULTIMODAL APPROACH TO THE TREATMENT OF ESOPHAGEAL CANCER
- ETHNIC PECULIARITIES OF DISTRIBUTION OF ACUTE MYELOBLASTIC LEUKAEMIA IN CHILDREN’S POPULATION IN KYRGYZSTAN