The improved gastric cancer survival reported from Japan and other countries -earlier detection and more radical surgery. Unfortunately, in our area gastric cancer is diagnosed in late stages. Methods: Review of 758 patients with primary gastric cancer consecutively admitted between 1990-2000. Results: 109(14.38%) patients -no operation, 146(19.26%) - laparotomy/laparoscopy, 43(5.67%) - bypass procedures, 63(8.31%) had feeding gastrostomy/jejunostomy, 397(52.57%) - gastric resections (198 distal subtotal gastrectomy, 199 total gastrectomy). 138 patients had gastrectomy with resection of another viscera (34.76% of all gastrectomy group). The influence of additional organ resections on morbidity and mortality ("the price") was an increase from 28.18% to 44.20% and from 10.27% to 14.73% respectively. The influence of additional organ resections on survival ("the profit") was visible only in stage III and IV with R0. Conclusions: Extended (additional organ) resections are associated with greater morbidity and mortality. The key to maximize survival is R0 resection with minimal extension. Additional organ resection can be justified only if needed to achieve R0.
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