En bloc resection for extensive XXXX : is it advisable?

@entity1 @entity157 @entity5 @entity3
When the adjacent organ is partially invaded by a @entity157 ( @entity157 ), whether to go on an aggressive resection is a difficult but challenging problem. To investigate the worth of en bloc resections, a retrospective controlled study was conducted. During a 9-year period, nine @entity1 (seven @entity1 , two @entity1 : group I) who had @entity157 with invasions to extrahepatic adjacent organs had undergone en bloc resections. The adjacent organs included diaphragm (eight cases), adrenal gland (two cases), abdominal wall (one case), and spleen (one case). The @entity1 selected for en bloc resections were those with a solitary @entity5 without evidence of vascular invasion or intravascular @entity5 thrombi, daughter nodule(s), or distant @entity3 . The evidence was based on preoperative evaluation by ultrasonography, computed tomography, arteriography, and intraoperative ultrasonography. Eighteen matched @entity1 with @entity157 but no involvement of neighboring organs were selected as controls (14 @entity1 , 4 @entity1 : group II). Though @entity1 of group I had wider invasion of @entity157 and more extensive resection, their surgical morbidity, mortality, hospital mortality, disease-free interval, and survival time were similar to those of group II, who had more limited @entity157 and resections. Eighteen months after operation, the @entity157 recurrence rate was 44% and 41% in groups I and II, respectively, and the percent survivals were 71% and 63%, respectively. We suggest that in cases of large @entity157 with local invasion to neighboring organs, aggressive en bloc resection is recommended after appropriate @entity1 selection.
