Between 1968 and 1983, out of 1,137 gastric cancer patients who underwent laparotomy, 344 patients had cancer invasion into a contiguous organ based on gross findings. The incideces of peritoneal dissemination, metastasis to the liver and extensive lymph node involvement were observed at the rates of 52.9%, 17.2% and 37.8%, respectively. Two hundred and twenty-one patients had gastrectomy with or without combined resection of other organs. The resectability rate was 62.9%. The commonly invaded organs were the pancreas(49.3%), transverse colon (13.1%), liver (10.4%), and diaphragma (5.9%). Combined resection of the stomach and the surrounding organ was performed in 139 patients (62.9%). The operative motality rate was 4.9%. The crude five-year survival rate for gastrectomy was 10.8% ; 27.4% in curative resection and 3.5% in non-curative resection. In contrast, none of the 123 patients in the non- resected group survived 3 years postoperatively. The results support that aggressive gastrectomy is indicated in selected patients as far as curability can be expected by means of combined resection.
Surgical Treatment of Gastric Cancer with Invasion Into the Contiguous Organs
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