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Extended multiorgan resection for T4 gastric carcinoma: 25‐year experience
Author(s) -
Carboni Fabio,
Lepiane Pasquale,
Santoro Roberto,
Lorusso Riccardo,
Mancini Pietro,
Sperduti Isabella,
Carlini Massimo,
Santoro Eugenio
Publication year - 2005
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20244
Subject(s) - medicine , multivariate analysis , gastric carcinoma , univariate analysis , resection , cancer , surgery , carcinoma , survival rate , survival analysis , gastroenterology
Abstract Background and Objectives In locally advanced gastric carcinoma infiltrating adjacent organs, an extended resection including invaded organs is required to improve the prognosis. We retrospectively analyzed our experience with extended multiorgan resection (EMR) in patients with advanced gastric cancer. Methods Between December 1979 and April 2004, 65 patients were resected for extended gastric carcinoma macroscopically invading other organs. Various clinicopathologic factors influencing early and late results were evaluated. Survival rates were calculated according to the Kaplan–Meier method. Prognostic factors were evaluated by univariate and multivariate analysis. Results The majority of patients (61.5%) did receive a R0 curative resection. In 52 (80%) of the 65 presumed T 4 cancers, histologic final analysis confirmed invasion. Postoperative morbidity and mortality was 27.7% and 12.3%, respectively. Actuarial 5‐year overall survival (OS) rate was 21.8%. It was significantly better in R0 versus R+ (30.6% vs. 0%, P = 0.001). Multivariate analysis identified curative resection as the strongest predictor of survival ( P = 0.002). Conclusions Patients with locally advanced gastric carcinoma invading adjacent organs can benefit from aggressive surgical treatment with acceptable morbidity and mortality. However, curative resection is mandatory to improve prognosis. J. Surg. Oncol. 2005;90:95–100. © 2005 Wiley‐Liss, Inc.