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Published in: Annals of Surgical Oncology 10/2009

01-10-2009 | Gastrointestinal Oncology

Clinical Impact of Positive Surgical Margin Status on Gastric Cancer Patients Undergoing Gastrectomy

Authors: Shang-Yu Wang, MD, Chun-Nan Yeh, MD, Hsiang-Lin Lee, MD, Yu-Yin Liu, MD, Tzu-Chieh Chao, MD, PhD, Tsann-Long Hwang, MD, FACS, Yi-Yin Jan, MD, FACS, Miin-Fu Chen, MD, FACS

Published in: Annals of Surgical Oncology | Issue 10/2009

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Abstract

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.
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Metadata
Title
Clinical Impact of Positive Surgical Margin Status on Gastric Cancer Patients Undergoing Gastrectomy
Authors
Shang-Yu Wang, MD
Chun-Nan Yeh, MD
Hsiang-Lin Lee, MD
Yu-Yin Liu, MD
Tzu-Chieh Chao, MD, PhD
Tsann-Long Hwang, MD, FACS
Yi-Yin Jan, MD, FACS
Miin-Fu Chen, MD, FACS
Publication date
01-10-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0616-0

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