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Updates in Surgery
Published in: Updates in Surgery 2/2018

01-06-2018 | Review Article

Resection line involvement after gastric cancer treatment: handle with care

Authors: Paolo Morgagni, Giuliano La Barba, Eleonora Colciago, Giovanni Vittimberga, Giorgio Ercolani

Published in: Updates in Surgery | Issue 2/2018

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Abstract

The optimal management of patients with resection line involvement after endoscopic or surgical treatment for gastric cancer is debated. In contrast to previous reports, we examined both the experience of endoscopists and surgeons in early-stage lesions and the wide variation in treatments proposed for advanced disease in case of infiltration of resection margins. A PubMed search for papers using the key words: gastric or stomach cancer, or Carcinoma; gastrectomy and positive margins; surgical margins or resection line or endoscopic margin involvement; and R1 resection, from January 2000 to July 2015 was undertaken. Fifty-three studies were considered pertinent to the study. Many endoscopists report that some cases of early gastric cancer with resection line involvement after endoscopic resection have good outcomes notwithstanding incomplete resection, but few surgeons share this opinion. Conversely, it is unanimously agreed that very advanced stages should not be surgically retreated because they are expression of systemic disease. Between early and very advanced cancer the usefulness of re-resection for microscopic resection lines involvement is still debated and surgery may be proposed only when radicality can be achieved. When surgery is not feasible, radiochemotherapy may represent a valid alternative.
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Metadata
Title
Resection line involvement after gastric cancer treatment: handle with care
Authors
Paolo Morgagni
Giuliano La Barba
Eleonora Colciago
Giovanni Vittimberga
Giorgio Ercolani
Publication date
01-06-2018
Publisher
Springer International Publishing
Published in
Updates in Surgery / Issue 2/2018
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-018-0552-2

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