Aim

Gastric cancer is the fifth most common cancer and the second leading cause of cancer-related deaths. Adjacent organ invasion is frequently observed in cases of gastric cancer which is often diagnosed in advanced stages in the Western countries. It is aimed to evaluate the effects of gastrectomy with multivisceral resection on health status and survival of patients with locally advanced gastric cancer.

Methods

The prospectively recorded data of 445 operated patients in the General Surgery Clinic at Dokuz Eylül University due to gastric cancer were reviewed. A total of 164 patients with locally invasive tumor detected during laparotomy or those in pT4 status according to post-resection pathologic staging were included in the study.

Results

One hundred and twenty patients underwent gastrectomy, 24 patients underwent gastrectomy with multivisceral resection, and 20 patients underwent palliative procedure. The patient groups were compared for demographic data, tumor location, preoperative biochemical analysis, hemoglobin values, and survival. The patients with palliative procedures were found to be significantly disadvantaged in terms of survival. There were no differences in the rates of R0 resection and postoperative complication between multivisceral resection group and only gastrectomy group. It was determined that survival of patients with multivisceral resection was significantly longer than palliative surgery patients.

Conclusion

Multivisceral resection in patients in whom R0 resection is possible, in those with a platelet/lymphocyte ratio of <130, neutrophil/lymphocyte ratio of <2.4, and with fewer than six metastatic lymph nodes, may provide increased survival periods without additional morbidity burden in experienced hands.

Keywords: Gastric cancer,multivisseral resection,locally advanced gastric cancer,R0 resection,platelet lymphocyte ratio,neutrophil lymphocyte ratio