[Clinical analysis of combined organ resection for T4b gastric cancer]

To evaluate the outcomes of combined organ resection for T4b gastric cancer, and determine the operative indication and prognostic factors.

Clinical data of 96 cases with T4bN0-3bM0 gastric cancer treated with combined organ resection in Tianjin Cancer Hospital from 2001 to 2005 were analyzed retrospectively.

Twelve patients developed postoperative complications, including pancreatic fistula (n=4), abdominal infection(n=5), pulmonary infection(n=3), all of which were managed with conservative treatment. There were no perioperative deaths. All the patients had postoperative follow up with a median of 73 months. The 1-, 3-, 5-year overall survival rates were 70.5%, 42.1%, and 23.5%, respectively. Univariate analysis showed that Borrmann type, histologic type, lymph node staging, and pancreatic invasion were associated with the survival in patients with T4b gastric cancer(both P<0.05). Multivariable analysis showed that lymph node staging and histologic type were independent prognostic factors(all P<0.05).

For well differentiated gastric cancer with lymph node staging of pN0 or pN1, combined organ resection may offer survival benefit.