Lokal ileri mide kanserlerinde en-blok multiorgan rezeksiyonu yapılan hastaların erken ve geç dönem sonuçları ve bu sonuçlara etki eden faktörler

Background and Aims: The aim of this study is to examine the early and late results of patients with adjacent organ invasion (cT4b) who were operated for locally advanced gastric cancer in a high-volume center and to investigate the factors affecting survival. Material and Methods: Patients who underwent gastrectomy and en-bloc adjacent organ resection due to locally advanced gastric cancer between 2015 and 2019 were included in the study. Results: Radical gastrectomy and en-bloc additional organ resection were performed in 54 patients out of 435 patients who were operated for gastric cancer due to clinical T4b tumors. The mean age of all patients was 61.87 ± 12.67years. The median survival was found to be 16.5 (1 - 72) months. First-year survival was achieved in 37 (68.5%) patients, three-year survival in 11 (20.3%) and five-year survival in only 4 (7.4%) patients. Considering the factors affecting long-term survival, it was seen that postoperative complications affected survival significantly (p = 0.04). We found that performing R1 resection (p = 0.001), large tumor diameter (p = 0.02), presence of lymphovascular invasion (p = 0.024) and presence of perineural invasion (p = 0.024) adversely affected long-term survival. Conclusion: Adequate lymph node dissection and en bloc R0 resection with adjacent organ are important for long-term survival in patients with clinical T4b gastric cancer. Surgery should be performed regardless of the T-stage of the tumor. In this respect, surgery performed with adequate R0 resection can be considered as an independent prognostic factor affecting survival. Other factors affecting long-term survival are lymph node metastasis, tumor size, post-operative complications, and vascular and perineural invasion.