Combined resection of the involved organs in T4 gastric cancer

Background/Aims: It remains controversial whether extended surgeries for ga stric cancer can improve the postoperative survival rate. This study was de signed to evaluate the effectiveness of a combined resection of the involve d organs for improving the survival of gastric cancer patients. Methodology: Of the 1600 patients treated at our Department, from 1969-1993 , 231 patients were found to have evidence of adjacent organ spread at lapa rotomy. Of the 231 patients, 174 underwent a combined resection of the adja cent organs with a gastrectomy due to direct invasion of these organs by th e gastric cancer. The clinicopathological character istics of 231 patients who had adjacent organ spread were compared retrospectively with 495 patien ts who had no adjacent organ spread. Results: Although the postoperative survival rate of those patients who und erwent a gastrectomy with a combined resection of the involved organs was p oor, 14 patients survived for 5 years or longer after the surgery. The clin icopathologic factors characteristic of these 14 surviving patients were a lesser extent of lymph node metastasis and high operative curability. Conclusions: A combined resection of the involved organs with a gastrectomy should be performed when lymph node metastasis is not evident.