Results of surgery in patients with gastric cancer extending to the adjacent organs.

Of 1,211 gastric cancer patients who underwent operations, 196 (16%) had cancers extending to the adjacent organs. Palliative procedures were performed in 66 (34%), and gastrectomies in 130 (66%). Operative mortality for the former was 6% (4/66), but was 0% for the latter. Among 130 gastrectomized patients 91 (70%) underwent combined resections of the invaded organs. With respect to the mean survival, significant differences were noted between gastrectomized (18 months) and non-gastrectomized patients (4 months), between the patients with (20 months) and without (12 months) combined resections, and between curative (27 months) and non-curative resections (13 months). Presence or absence, and degree of peritoneal, liver and lymph node metastases were also prognostic among gastrectomized patients. Combined resections of the involved organs showed slight, but positive, effects on survival of patients with liver metastases, but they seemed to be ineffective in the presence of peritoneal metastases. In the case of patients with apparently incurable factors such as P2-3, H2-3 or N4, gastrectomy was prognostically ineffective.