title: [Multiorgan resection in patients with gastric cancer].
abstract: BACKGROUND
  Multiorgan resection for a malignancy is a very complicated procedure, but there is always the question: does it work? In everyday clinical practice gastric cancer in phases III and IV is rather frequent. Unfortunately, our patients are under the age of 55 years. D2 lymphadenectomy is not as extensive as D2 +/ or D3, so one must ask himself if multiorgan resection is worth the risk
  
  
  METHODS
  We evaluated two groups of patients: group I consisted of 34 patients who underwent total or subtotal gastrectomy, systematic lymphadenectomy and resection of one or more organs; group II (control) consisted of 167 patients who underwent total or subtotal gastrectomy and systematic lymphadenectomy. These two groups of patients were analzyed in regard to: Bormann's classification, histopathologic type, early mortality, early postoperative complications, lymph node dissection and long-term survival.
  
  
  RESULTS
  According to Bormann's classification the most common type of carcinoma in both groups was ulcerovegetativ tumor (70.6% in I and 58% in II). In the first group of patients a great number of patients had poorly differentiated adenocarcinomas (47%), while in the second group the most common histologic type was well differentiated intestinal carcinoma (28%). Patients with multiorgan resections had higher rates of early postoperative mortality and morbiditiy (mortality--14.7% and complications--26.5%) than patients in control group (mortality--4.8% and complications--11.4%). The most frequent causes of postopertive mortality and morbidity were anastomotic leakage and wound infections in both groups. Metastatic lymph node invelvement was higher in the first group (41%), than in the second (28%). Long-term survival was best in the control group (38.5 months). Patients with multiorgan resection had better survival (25.4 months) than inoperable cases (only 5 months).
  
  
  CONCLUSIONS
  Patients undergoing multiorgan resection usually have advanced gastric cancer with tumor infiltration in surrounding structures. Only these cases are absolute indications for this radical operation, because patients have better chances for survival.
  
  
  CONCLUSIONS
  Multiorgan resections are extensive procedures with high rates of postoperative mortality and morbidity, but represent the only way for better survival of patients with advanced gastric cancer.
authors.affiliation: Klinika za hirurgiju, Klinicko-bolnicki centar Dr Dragisa Misović, Beograd. saga@arkayu.net
authors.forename: Dragan
authors.initials: D
authors.lastname: Radovanović
authors.forename: Dejan
authors.initials: D
authors.lastname: Stevanović
authors.forename: Ivan
authors.initials: I
authors.lastname: Pavlović
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Bajec
authors.forename: Berislav
authors.initials: B
authors.lastname: Vekić
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Mitrović
mesh_terms: D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D011183:Postoperative Complications; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D014781:Viscera / Q000601:surgery