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Appropriate selection of patients for combined organ resection in cases of gastric carcinoma invading adjacent organs
Author(s) -
Jeong Oh,
Choi Won Yong,
Park Young Kyu
Publication year - 2009
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.21306
Subject(s) - medicine , surgery , lymph node , metastasis , resection , cancer , carcinoma , lymph node metastasis
Background and Objectives Proper patient selection for multi‐organ resection in T4 gastric carcinoma remains controversial. Our aim was to investigate which patients might benefit from multi‐organ resection. Methods Among 1,775 consecutive patients receiving gastric cancer surgery, 71 had adjacent organ invasion. Short‐ and long‐term surgical outcomes and associations between clinicopathological factors and overall survival were investigated. Results Forty‐seven patients underwent curative surgery with multi‐organ resection, and 24 underwent non‐curative surgery, with or without multi‐organ resection. Postoperative morbidity and mortality rates were 31.7% and 3.3%, respectively. Patients receiving curative surgery via multi‐organ resection survived longer than those without (MST, 31.5 months vs. 19.1 months, P = 0.046). Multi‐organ resection did not affect survival when performed in non‐curative surgery. N3 lymph node metastasis was an independent prognostic factor for poor outcome (HR = 3.89, 95% CI = 1.40–10.83) in curatively resected patients; patients with N3 lymph node metastasis showed similar survival to patients receiving non‐curative surgery. Conclusion Multi‐organ resection should be performed only when no incurable factors are present, and R0 resection is most likely. Multi‐organ organ resection does not, however, seem to be effective in patients with N3 lymph node metastasis, even when curative resection is performed. J. Surg. Oncol. 2009;100:115–120. © 2009 Wiley‐Liss, Inc.