Risk factors for liver dysfunction and their clinical importance after gastric cancer surgery

Area of Science:

• Gastroenterology and Hepatology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Postoperative liver dysfunction, indicated by abnormal hepatobiliary enzymes, is a concern in gastric cancer (GC) surgery.
• Identifying risk factors and clinical impact is crucial for managing patients undergoing GC surgery.

Purpose of the Study:

• To identify risk factors for postoperative liver dysfunction following gastric cancer surgery.
• To evaluate the clinical impact of postoperative liver dysfunction on patient outcomes.

Main Methods:

• Retrospective analysis of 124 gastric cancer patients who underwent laparoscopic or robotic surgery.
• Data collected between 2017 and 2019 at Kyoto Prefectural University of Medicine.
• Postoperative liver dysfunction defined by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 ≥ Grade 3.

Main Results:

• 16.1% of GC patients developed postoperative liver dysfunction.
• Univariate analysis identified robotic surgery as a significant risk factor (P=0.005).
• No correlation found between liver dysfunction and postoperative complications or hospital stay.
• No significant difference in overall survival or recurrence-free survival between groups.

Conclusions:

• Robotic surgery is identified as a risk factor for postoperative liver dysfunction in gastric cancer patients.
• Postoperative liver dysfunction does not appear to negatively affect short-term or long-term patient outcomes.