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Therapeutic Approach to cT4b Gastric Cancer

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Gastric Cancer: the 25-year R-Evolution

Part of the book series: Updates in Surgery ((UPDATESSURG))

Abstract

The therapeutic approach to locally advanced gastric cancer with invasion of adjacent organs is still unclear. Some studies have shown the feasibility and potential benefit of extended resections of the stomach and adjacent involved organs, in particular when a R0 resection can be achieved. Conversely, other studies reported a higher risk for perioperative morbidity and mortality, with limited benefits in terms of survival, suggesting this approach only for well-selected cases. Many potential clinicopathologic prognostic factors, such as age, tumor size, histotype, pathological depth of invasion, nodal status, distant metastasis, number and type of resections, have been proposed; however, the prognostic value of multivisceral resections in this subset of patients remains controversial. In this chapter, we analyze the state of the art in locally advanced (cT4b) gastric cancer, paying particular attention to the short- and long-term outcomes of extended surgery, the prognostic value of clinicopathological factors, and the potential role of neoadjuvant/multimodality approach.

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Author information

Authors and Affiliations

  1. Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy

    Daniele Marrelli

  2. Unit of Digestive Surgery, Department of Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

    Fausto Rosa

  3. Unit of Diagnostic Imaging, Department of Radiological Sciences, University Hospital of Siena, Siena, Italy

    Giulio Bagnacci

  4. Department of Biotechnologies, University of Siena, Siena, Italy

    Chiara Defraia

Authors
  1. Daniele Marrelli
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  2. Fausto Rosa
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  3. Giulio Bagnacci
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  4. Chiara Defraia
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Corresponding author

Correspondence to Daniele Marrelli .

Editor information

Editors and Affiliations

  1. Division of General and Upper Gastrointestinal Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy

    Giovanni de Manzoni

  2. Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy

    Franco Roviello

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Marrelli, D., Rosa, F., Bagnacci, G., Defraia, C. (2022). Therapeutic Approach to cT4b Gastric Cancer. In: de Manzoni, G., Roviello, F. (eds) Gastric Cancer: the 25-year R-Evolution. Updates in Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-73158-8_17

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  • DOI: https://doi.org/10.1007/978-3-030-73158-8_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-73157-1

  • Online ISBN: 978-3-030-73158-8

  • eBook Packages: MedicineMedicine (R0)

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