Multivisceral resection for locally advanced gastric cancer: A retrospective study

Multivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis. We retrospectively reviewed cT4b gastric cancer patients who underwent surgery...

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Bibliographic Details
Published in:The American journal of surgery 2021-05, Vol.221 (5), p.1011-1017
Main Authors: Yang, Yanpeng, Hu, Jianwen, Ma, Yongchen, Chen, Guowei, Liu, Yucun
Format: Article
Language:English
Subjects:
Cancer
Cancer therapies
Chemotherapy
Gastric cancer
Gastrointestinal surgery
Lymph nodes
Lymphatic system
Medical prognosis
Medical records
Morbidity
Mortality
Multivariate analysis
Multivisceral resection
Ostomy
Pancreas
Patients
Prognostic factors
Regression analysis
Surgery
Survival
Survival analysis
Survival rate
T4b gastric Cancer
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Summary:Multivisceral resection may be the exclusive radical procedure for cT4b gastric cancer patients. However, most surgeons refuse to select surgery because of the theoretical higher mortality, morbidity and poorer prognosis. We retrospectively reviewed cT4b gastric cancer patients who underwent surgery from January 1,1997 to December 31,2018. The primary endpoint was overall survival. Short-term results and prognostic values of clinical and pathologic factors were also analyzed. Patients underwent multivisceral resection had an acceptable mortality and morbidity. The overall 5-year survival rate of multivisceral resection was higher than that of palliative surgery (P 15), vascular cancer emboli, and postoperative chemotherapy. Conclusions: cT4b gastric cancer patients underwent multivisceral resection experience acceptable mortality and morbidity. The independent prognostic factors for multivisceral resection were completeness of resection, extensive lymph node involvement (>15), vascular cancer emboli, and postoperative chemotherapy. •CT4b gastric cancer patients could benefit from multivisceral resection.•R0 resection is independent prognostic factor for multivisceral resection.•CT4bN3b gastric cancers should be excluded from multivisceral resection.•≥6 cycles chemotherapy should be performed after multivisceral resection.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2020.09.037