Management by en bloc multiple organ resection of carcinoma of the stomach invading adjacent organs.

During the period of 1949 to 1971, 72 patients at this cancer center underwent en bloc multiple organ resection with curative intent for adenocarcinoma of the stomach that had invaded adjacent organs and structures. The over-all five year survival rate was 7 per cent and the operative mortality, 37.5 per cent. Patients with advanced stage tumors did poorly, although relief of symptoms and some prolongation of survival time were evident. Those patients with early staged tumors limited to the stomach and adjacent perigastric lymph nodes had a remarkable salvage rate of 31 per cent for a corresponding operative mortality of 25 per cent. Most of the postoperative complications and deaths occurred in the earlier period of the study and are preventable with present day surgical management; few deaths occurred during the last five years of the study. In the absence of detectable distant metastases, aggressive resection of these tumors is warranted in carefully selected patients with reasonable prospects of cure and palliation.