Prognostic impact of resection margin involvement after extended (D2/D3) gastrectomy for advanced gastric cancer: A 15-year experience at a single institute
✍ Scribed by Byoung Chul Cho; Hei Cheul Jeung; Hye Jin Choi; Sun Young Rha; Woo Jin Hyung; Jae Ho Cheong; Sung Hoon Noh; Hyun Cheol Chung
- Publisher
- John Wiley and Sons
- Year
- 2007
- Tongue
- English
- Weight
- 146 KB
- Volume
- 95
- Category
- Article
- ISSN
- 0022-4790
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✦ Synopsis
Abstract
Background and Objectives
The aim of this study was to investigate whether microscopic positive margins are detrimental to the outcome of gastric cancer patients treated with extended (D2/3) gastrectomy.
Methods
Among 2,740 consecutive patients who had undergone extended gastrectomy for advanced gastric cancer between January 1987 and December 2002, 49 patients (1.8%) had positive resection margins on final histology.
Results
Among 49 patients, 29 (59.2%) had proximal involved margins and 20 (40.8%) had distal involved margins. The median survival time of the positive margin group was 34 months. The negative margin group had a significantly longer median survival time of 69 months (P = 0.025). When both groups of patients were stratified according to nodal stage, a positive resection margin determined a worse prognosis only in patients with node‐negative disease (174 months vs. 37 months, P = 0.0001). In patients with nodal metastasis, the median survival time was similar in both groups.
Conclusions
Our results suggest that a positive microscopic margin is associated with a worse outcome in patients with node‐negative disease. Therefore, a more aggressive treatment, such as re‐operation, is needed in node‐negative patients with a positive microscopic disease. J. Surg. Oncol. 2007; 95: 461–468. © 2006 Wiley‐Liss, Inc.