Extended multiorgan resection for T4 gastric carcinoma: 25-Year experience

Fabio Carboni, Pasquale Lepiane, Roberto Santoro, Riccardo Lorusso, Pietro Mancini, Isabella Sperduti, Massimo Carlini, Eugenio Santoro

Research output: Contribution to journalArticle

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 T4 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.

Original languageEnglish
Pages (from-to)95-100
Number of pages6
JournalJournal of Surgical Oncology
Volume90
Issue number2
DOIs
Publication statusPublished - May 1 2005

Keywords

  • Advanced stage and survival
  • Gastric cancer
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Oncology

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