Short-term safety and Long-term efficacy of multivisceral resection in pT4b gastric cancer patients without distant metastasis: a 20-year experience in China National Cancer Center.

Multivisceral resection is occasionally necessary for pT4b gastric cancer patients to achieve negative margin. The purpose of this study is to assess the short-term safety and long-term efficacy of this approach. A single-center, retrospective analysis was conducted for pT4b gastric cancer patients after curative-intent multivisceral resection from the China National Cancer Center Gastric Cancer Database (NCCGCDB) from 1998 to 2018. The postoperative complications, recurrence patterns, long-term survival, and prognostic factors were analyzed. A total of 210 patients were included in the study. The most common combined resection organs were multiple organs (30.5%), pancreas (20.5%), colon (16.7%), and liver (9.0%). Seventeen patients (8.1%) developed postoperative complications and hospital death was observed in one patient (0.5%). The most common postoperative complications were anastomotic leak (4.3%) and intra-abdominal infection (5.7%). The 3-year and 5-year disease-free survival (DFS) rates for the patients investigated were 38.0% and 33.8%, respectively, and the 3-year and 5-year overall survival (OS) rates were 48.2% and 39.1%, respectively. Multivariate Cox regression analysis proved that negative nerve invasion was independent risk factors for DFS (HR: 2.202, 95%CI: 1.144-4.236, =0.018) and OS (HR: 2.219, 95%CI: 1.164-4.231, =0.015). Multivisceral resection in pT4b gastric cancer patients without distant metastasis was effective and had an acceptable safety profile.