caa a22 4500 445333596 CHVBK 20180317142745.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1245/s10434-010-1534-x doi (NATIONALLICENCE)springer-10.1245/s10434-010-1534-x Aggressive Surgical Approach for Patients with T4 Gastric Carcinoma: Promise or Myth? [Elektronische Daten] [Chi-Tung Cheng, Chun-Yi Tsai, Jun-Te Hsu, Rohan Vinayak, Keng-Hao Liu, Chun-Nan Yeh, Ta-Sen Yeh, Tsann-Long Hwang, Yi-Yin Jan] Background: Surgical outcomes of multiorgan resection (MOR) for T4 gastric carcinoma reported in the literature are widely variable. We herein report a large surgical series of T4 gastric carcinoma. Methods: One hundred seventy-nine patients with cT4 gastric carcinoma were recruited onto the study. Patient characteristics, surgical strategy and related complications, long-term survival, and prognostic factors of T4 gastric carcinoma were analyzed. Results: Of 179 cT4 gastric carcinoma, there were 57 cT4 (pT3) with MOR, 91 pT4 with MOR, and 31 cT4 without MOR. pT4 with MOR were more likely to be associated with nodal metastasis, cellular dedifferentiation, and lymphoperineural infiltration compared to those of pT0-3 (P<0.01 for all). For 91 pT4 with MOR, their surgical mortality and morbidity rates were 4.4 and 28.6%, respectively; their 1-, 3-, and 5-year overall survival rates were 55.2, 22.4, and 12.2%, respectively. The long-term survival of cT4 (pT3) with MOR was superior to pT4 with MOR (P=0.006) and cT4 without MOR (P=0.004). There was a striking difference between pT4 with MOR, R0 and pT4 with MOR, and R1 or R2 (P=0.007). By means of multivariate analysis, lymph node status, liver invasion, and positive surgical margin were independent prognostic factors. Conclusions: Aggressive surgical management of pT4 gastric carcinoma should be limited to patients without adverse prognostic factors such as advanced nodal involvement and pancreatic invasion. Society of Surgical Oncology, 2011 Cheng Chi-Tung Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut Tsai Chun-Yi Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut Hsu Jun-Te Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut Vinayak Rohan Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut Liu Keng-Hao Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut Yeh Chun-Nan Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut Yeh Ta-Sen Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut Hwang Tsann-Long Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut Jan Yi-Yin Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1606-1614 1068-9265 18:6<1606 2011 18 10434 https://doi.org/10.1245/s10434-010-1534-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1534-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cheng Chi-Tung Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Tsai Chun-Yi Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Hsu Jun-Te Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Vinayak Rohan Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Liu Keng-Hao Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Yeh Chun-Nan Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Yeh Ta-Sen Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Hwang Tsann-Long Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Jan Yi-Yin Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taipei, Taiwan aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1606-1614 1068-9265 18:6<1606 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer