Prognostic factors in patients with advanced gastric cancer with macroscopic invasion to adjacent organs treated with radical surgery

被引:41
作者
Isozaki H. [1 ]
Tanaka N. [1 ]
Tanigawa N. [2 ]
Okajima K. [2 ]
机构
[1] First Department of Surgery, Okayama University Medical School, Okayama 700-8558
[2] Department of General and Gastoenterological Surgery, Osaka Medical College, Osaka
关键词
Extended lymph node dissection; Gastric cancer; Location of tumor; Lymph node metastasis; Macroscopic T4; Prognostic factors; Radical surgery;
D O I
10.1007/PL00011718
中图分类号
学科分类号
摘要
Background. The prognosis of patients with gastric cancer with invasion to adjacent organs is poor. The prognostic factors of patients with advanced gastric cancer with macroscopic invasion to adjacent organs (T4) who were treated with radical surgery was determined in the present study. Methods. A total of 86 consecutive patients with advanced gastric cancer who underwent radical (potentially curable) gastrectomy with combined resection of other organs for macroscopic invasion to adjacent organs during surgery, were investigated. The organs invaded macroscopically were the pancreas in 43 patients, mesocolon in 29, liver in 7, transverse colon in 5, adrenal gland in 3, spleen in 1, diaphragm in 1, and other organs in 5. The prognostic factors were evaluated by univariate and multivariate analysis. Results. The cumulative 5-year survival rate of the patients treated by radical surgery with the combined resection of invaded organs was 35.0%. Multivariate analysis demonstrated that location of the tumor, lymph node metastasis, histological depth of invasion, and extent of lymph node dissection were significant prognostic factors in advanced gastric cancer patients treated by radical surgery with combined resection of adjacent organs for macroscopic invasion. Conclusion. For patients with macroscopic T4 gastric cancer located in the middle- or lower-third of the stomach, aggressive resection of invaded adjacent organs with extended lymph node dissection should be performed to improve long-term outcome.
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页码:202 / 210
页数:8
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