Giris ve Amaç: Bu çalismanin amaci, yüksek volümlü bir merkezde lokal ileri mide kanseri nedeniyle opere edilen komsu organ invazyonu (cT4b) olan hastalarin erken ve geç sonuçlarini incelemek ve sagkalimi etkileyen faktörleri arastirmaktir. Gereç ve Yöntem: 2015-2019 yillari arasinda lokal ileri mide kanseri nedeniyle gastrektomi ve en-blok komsu organ rezeksiyonu yapilan hastalar çalismaya dahil edildi. Bulgular: Klinik T4b tümörü nedeniyle mide kanseri nedeniyle ameliyat edilen 435 hastanin 54’üne radikal gastrektomi ve en-blok ek organ rezeksiyonu uygulandi. Tüm hastalarin yas ortalamasi 61.87 ± 12.67 idi. Ortanca sagkalim 16.5 (1 - 72) ay olarak bulundu. 37 (%68.5) hastada birinci yil sagkalim, 11 (%20.3) hastada üç yillik sagkalim ve sadece 4 (%7.4) hastada bes yillik sagkalim saglandi. Uzun dönem sagkalimi etkileyen faktörlere bakildiginda postoperatif komplikasyonlarin sagkalimi anlamli olarak etkiledigi görüldü (p = 0.04). R1 rezeksiyon (p = 0.001), büyük tümör çapi (p = 0.02), lenfovasküler invazyon (p = 0.024) ve perinöral invazyon (p = 0.024) varliginin uzun dönem sagkalimi olumsuz etkiledigini bulduk. Sonuç: Klinik T4b mide kanserli hastalarda yeterli lenf nodu diseksiyonu ve komsu organla en-blok R0 rezeksiyonu uzun dönem sagkalim için önemlidir. Tümörün T-evresi ne olursa olsun cerrahi yapilmalidir. Bu açidan yeterli R0 rezeksiyon ile yapilan cerrahi, sagkalimi etkileyen bagimsiz bir prognostik faktör olarak degerlendirilebilir. Uzun süreli sagkalimi etkileyen diger faktörler, lenf nodu metastazi, tümör boyutu, ameliyat sonrasi komplikasyonlar ve vasküler ve perinöral invazyondur
Background and Aims: The aim of this study is to examine the early and late results of patients with adjacent organ invasion (cT4b) who wereoperated for locally advanced gastric cancer in a high-volume center and to investigate the factors affecting survival. Material and Methods:Patients who underwent gastrectomy and en-bloc adjacent organ resection due to locally advanced gastric cancer between 2015 and 2019 wereincluded in the study. Results: Radical gastrectomy and en-bloc additional organ resection were performed in 54 patients out of 435 patients whowere operated for gastric cancer due to clinical T4b tumors. The mean age of all patients was 61.87 ± 12.67 years. The median survival was foundto be 16.5 (1 - 72) months. First-year survival was achieved in 37 (68.5%) patients, three-year survival in 11 (20.3%) and five-year survival in only4 (7.4%) patients. Considering the factors affecting long-term survival, it was seen that postoperative complications affected survival significantly(p = 0.04). We found that performing R1 resection (p = 0.001), large tumor diameter (p = 0.02), presence of lymphovascular invasion (p = 0.024)and presence of perineural invasion (p = 0.024) adversely affected long-term survival. Conclusion: Adequate lymph node dissection and en blocR0 resection with adjacent organ are important for long-term survival in patients with clinical T4b gastric cancer. Surgery should be performedregardless of the T-stage of the tumor. In this respect, surgery performed with adequate R0 resection can be considered as an independent prognostic factor affecting survival. Other factors affecting long-term survival are lymph node metastasis, tumor size, post-operative complications,and vascular and perineural invasion