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Multivisceral resection vs standard gastrectomy for gastric adenocarcinoma
Author(s) -
Dias Andre R.,
Pereira Marina A.,
Oliveira Rodrigo J.,
Ramos Marcus F. K. P.,
Szor Daniel J.,
Ribeiro Ulysses,
Zilberstein Bruno,
Cecconello Ivan
Publication year - 2020
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.25862
Subject(s) - medicine , gastrectomy , odds ratio , cancer , surgery , adenocarcinoma , gastroenterology , cohort
Multivisceral resection (MVR) is potentially curative for selected gastric cancer patients, supposedly at the cost of increased complications. However, current data comparing MVR to standard gastrectomy (SG) is lacking. Objectives Compare complications and survival after MVR and SG. Methods In a retrospective cohort of 1015 patients with gastric adenocarcinoma, 58 underwent MVR and 466 SG. Groups were compared concerning their characteristics, complications, and survival. Results One hundred seventy‐six patients had postoperative complications. Major complications were more frequent after MVR ( P = .002). Surgical mortality was 8.6% and 4.9% for MVR and SG ( P = .221). Older age, higher morbidities, and MVR were independent risk factors for major complications. The odds ratio for major complications was 5.89 for MVR with one or two organs and 38.01 for MVR with three or more organs. The pancreas was the most commonly removed organ and pT4b disease were confirmed in 34 (58.6%) of the MVR cases. Disease‐free survival (DFS) was lower in MVR patients (51% vs 77.8%; P < .001), being worse according to the number of organs resected. In pN+ patients, DFS was worse after MVR. DFS was equivalent to pT4b and non‐pT4b in the MVR group. Conclusions Increased morbidity and lower survival are expected for gastric cancer patients undergoing MVR.