Surgery in the Multimodal Management of Gastric Cancer

The role of multivisceral resection in the setting of locally advanced gastric cancer is still unclear. Previous study studies have reported a higher risk of perioperative morbidity and mortality, with little objective benefit in survival. Accordingly, this approach has been recommended only for selected cases. By contrast, recent studies have shown the feasibility of enlarged resections and the potential advantage of extended resection for clinical T4bN0 gastric adenocarcinoma, with good long-term results. In this chapter, we analyze the state of the art of multivisceral resection for locally advanced gastric cancer, paying particular attention to the short- and long-term outcomes and to the prognostic value of many clinicopathological factors.