BACKGROUND: The clinical impact of positive surgical margin on the overall survival and recurrence pattern for gastric cancer (GC) patients undergoing intension curative resection has not yet been well investigated. PATIENTS AND METHODS: The clinical features of 1,565 patients with histologically proven GC who underwent intension curative resection from 1994 to 2004 were retrospectively reviewed. Among them, 129 (8.2%) had positive microscopic resection margin. The clinicopathological features and the outcome of 1,436 GC patients undergoing gastrectomy with negative resection margin were used for comparison. RESULTS: GC patients who underwent gastrectomy with higher T, N stage, and tumor size larger than 5 cm tended to have positive resection margin when compared with those with negative margin. Median follow-up duration for the 1,565 GC patients who underwent intension curative resection was 28.6 months. The overall survival (OS) rate significantly decreased when the patients had positive resection margin, irrespective of different stages. When GC patients underwent gastrectomy with positive resection margin, positive nodal metastasis determined the worst OS. Distant metastasis was the most common site of recurrence, followed by peritoneal and locoregional recurrence. CONCLUSIONS: Aggressive tumor biology might be the main factor contributing to positive microscopic resection margin after gastrectomy. Positive resection margin had a definite unfavorable impact on the OS of gastric cancer patients undergoing gastrectomy. When GC patients underwent gastrectomy with positive resection margin, positive nodal metastasis determined the worst OS, and distant metastasis was the most common site of recurrence.
BACKGROUND: The clinical impact of positive surgical margin on the overall survival and recurrence pattern for gastric cancer (GC) patients undergoing intension curative resection has not yet been well investigated. PATIENTS AND METHODS: The clinical features of 1,565 patients with histologically proven GC who underwent intension curative resection from 1994 to 2004 were retrospectively reviewed. Among them, 129 (8.2%) had positive microscopic resection margin. The clinicopathological features and the outcome of 1,436 GC patients undergoing gastrectomy with negative resection margin were used for comparison. RESULTS: GC patients who underwent gastrectomy with higher T, N stage, and tumor size larger than 5 cm tended to have positive resection margin when compared with those with negative margin. Median follow-up duration for the 1,565 GC patients who underwent intension curative resection was 28.6 months. The overall survival (OS) rate significantly decreased when the patients had positive resection margin, irrespective of different stages. When GC patients underwent gastrectomy with positive resection margin, positive nodal metastasis determined the worst OS. Distant metastasis was the most common site of recurrence, followed by peritoneal and locoregional recurrence. CONCLUSIONS:Aggressive tumor biology might be the main factor contributing to positive microscopic resection margin after gastrectomy. Positive resection margin had a definite unfavorable impact on the OS of gastric cancerpatients undergoing gastrectomy. When GC patients underwent gastrectomy with positive resection margin, positive nodal metastasis determined the worst OS, and distant metastasis was the most common site of recurrence.
Authors: Jung-Woo Woo; Keun Won Ryu; Ji Yeon Park; Bang Wool Eom; Mi Jung Kim; Hong Man Yoon; Sook Ryun Park; Myeong-Cherl Kook; Il Ju Choi; Young-Woo Kim; Young-Iee Park Journal: World J Surg Date: 2014-02 Impact factor: 3.352
Authors: Nelson Adami Andreollo; Eric Drizlionoks; Valdir Tercioti-Junior; João de Souza Coelho-Neto; José Antonio Possato Ferrer; José Barreto Campello Carvalheira; Luiz Roberto Lopes Journal: Arq Bras Cir Dig Date: 2019-12-20