title: Results of combined complete removal of directly invaded organs with the stomach in patients with advanced gastric cancer.
abstract: OBJECTIVE
  The prognosis of some patients with gastric tumors that have infiltrated adjacent organs may be improved by operations that include complete removal of these structures. However, such a radical operation raises concerns about operative risk.
  
  
  METHODS
  We performed a retrospective analysis of 55 patients whose gastric primary tumors invaded adjacent organs to evaluate the effect of combined removal on postoperative survival. Prognostic factors were also determined by the univariate and multivariate analysis.
  
  
  RESULTS
  Cumulative 5-year survival of patients who underwent complete removal of invaded organs was significantly higher than that of patients who did not undergo complete removal of invaded organs or gastrectomy alone. No significant difference was noted between groups in mortality at 30 days after operation. Univariate and multivariate analysis seeking prognostic factors revealed that completeness of the combined removal of invaded organs was among the predictors of outcome.
  
  
  CONCLUSIONS
  In conclusion, our study suggested that complete removal of invaded organs simultaneously with gastrectomy can prolong postoperative survival of patients with gastric cancer directly invading adjacent organs.
authors.affiliation: Department of Surgery, Kyoto Prefectural University of Medicine, Kawaramachi, Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Sawai
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Akeo
authors.initials: A
authors.lastname: Hagiwara
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Yamagishi
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome