Surgical outcomes and survival after multiorgan resection for locally advanced gastric cancer

• Published in: The American journal of surgery 2009-07, Vol.198 (1), p.25-30
• Main Authors: Ozer, Ilter, M.D, Bostanci, E. Birol, M.D, Orug, Taner, M.D, Ozogul, Yusuf B., M.D, Ulas, Murat, M.D, Ercan, Metin, M.D, Kece, Can, M.D, Atalay, Fuat, M.D, Akoglu, Musa, M.D
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Adult; Age; Aged; Aged, 80 and over; Antibiotics; Biological and medical sciences; Cancer; Esophagectomy - methods; Female; Follow-Up Studies; Gastrectomy; Gastrectomy - methods; Gastric cancer; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; Locally advanced; Lymph; Lymph nodes; Lymphatic system; Male; Medical prognosis; Medical sciences; Metastases; Metastasis; Middle Aged; Morbidity; Mortality; Multivariate analysis; Neoplasm Invasiveness - pathology; Neoplasm Metastasis; Neoplasm Staging; Organs; Patients; Resection; Retrospective Studies; Splenectomy - methods; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Surgical outcomes; Survival; Survival Rate - trends; Time Factors; Treatment Outcome; Tumors
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2008.06.031

Abstract Background Multiple organ resection for locally advanced (assumed T4) gastric cancer is associated with high morbidity and mortality. Our aim was to evaluate the efficacy of these surgeries with regard to surgical morbidity, mortality, and survival. Methods Fifty-six patients underwent potentially radical gastrectomy combined with invaded organ resection. Early and late results of multiorgan resection and clinicopathologic factors influencing these results were evaluated. Results Forty patients (71.4%) received 1 additional organ resection and 16 patients (28.6%) received 2 or more additional organ resections. Postoperative morbidity and mortality was 37.5% and 12.5%, respectively. Resection of 2 or more additional organs increased postoperative morbidity and advanced age increased mortality. The 1- and 3-year survival rates were 53.3% and 28.1%, respectively. Advanced age, lymph node metastasis, and resection of more than 1 additional organ were significant prognostic factors for survival. Conclusions For patients with locally advanced gastric carcinoma, multiple organ resection is worthwhile with careful patient selection.