title: [Application value of combined organ radical resection in patients with recurrent gastric cancer].
abstract: OBJECTIVE
  To investigate the outcomes after combined organ radical resection for the recurrent gastric cancer.
  
  
  METHODS
  Complete clinicopathological data of 48 recurrent gastric cancer patients who received radical resection before and underwent reoperation again in the Sun Yat-sen Memorial Hospital and The Second Affiliated Hospital of Xinjiang Medical University from January 2008 to December 2013 were analyzed retrospectively. Of 48 patients, 32 received combined organ radical resection(radical group) and 16 received combined organ palliative gastric stump resection (palliative group).
  
  
  RESULTS
  In the radical group, one case(3.1%,1/32) died 5 days after operation due to hepatorenal syndrome and 9 had postoperative complications (28.1%,9/32), including external intestinal fistula, pancreatic fistula, biliary fistula and anastomotic bleeding. In the palliative group, only one patient(6.2%, 1/16) had postoperative pneumonia and partial intestinal obstruction, with lower complication morbidity as compared to the radical group(P<0.05). The median survival time was significantly longer in the radical group(36.0 vs. 11.5 months, P<0.01). The 1- and 3-year survival rates were 93.1%, 72.4% in the radical group, and 31.3%, 18.8% in palliative group, whose differences were statistically significant. Multivariate Cox regression analysis showed that clinical stage (HR:3.106, 95% CI:1.357-6.321, P=0.008), peritoneal metastasis (HR:10.167, 95% CI:3.230-35.234, P=0.000) and radical cure situation(HR:3.256, 95% CI:1.267-9.389, P=0.009) were independent prognostic factors.
  
  
  CONCLUSIONS
  The combined organ radical resection can provide better survival for recurrent gastric cancer patients, while the indications should be controlled strictly with preoperative multidisciplinary assessment and precise surgical judgment in order to decrease the complication.
authors.affiliation: Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China. junzhougp@126.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830063, China.
authors.forename: Junli
authors.initials: J
authors.lastname: Hou
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830063, China.
authors.forename: Jianhui
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830063, China.
authors.forename: Tabusi
authors.initials: T
authors.lastname: Ahetibieke
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830063, China.
authors.forename: Aisha
authors.initials: A
authors.lastname: Abudousimu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Xinjiang Medical University, Urumqi 830063, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Ma
authors.affiliation: Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
mesh_terms: D005743:Gastrectomy; D018530:Gastric Stump / Q000601:surgery; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D015996:Survival Rate