Surgical outcomes and survival after extended multiorgan resection for T4 gastric cancer.

BACKGROUND: Extended multiorgan resection (EMR) for locally advanced (T4) gastric cancer remains controversial. The aim of this study was to evaluate the effectiveness of this approach with regard to morbidity, mortality, and survival. METHODS: Between 2005 and 2009, 41 patients underwent aggressive surgery for clinical T4 gastric cancer. Univariate and multivariate analyses were used to identify prognostic factors for surgical outcomes and survival in these patients. RESULTS: Curative resection was performed in 29 patients (70.7%); postoperative morbidity and mortality rates were 17.1% and 4.9%, respectively. The survival rate in R0 resection patients was significantly longer than that in patients undergoing R1 or R2 resection. Multivariate analysis identified resectability and tumor size (>= 10 cm) as independent prognostic factor for patients with T4 gastric cancer undergoing combined resection. CONCLUSIONS: EMR should be performed for patients with T4 gastric cancer in whom curative resection can be used. (C) 2012 Elsevier Inc. All rights reserved.