Clinical impact of positive surgical margin status on gastric cancer patients undergoing gastrectomy

Shang Yu Wang*, Chun Nan Yeh, Hsiang Lin Lee, Yu Yin Liu, Tzu Chieh Chao, Tsann Long Hwang, Yi Yin Jan, Miin Fu Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

101 Scopus citations

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.

Original languageEnglish
Pages (from-to)2738-2743
Number of pages6
JournalAnnals of Surgical Oncology
Volume16
Issue number10
DOIs
StatePublished - 10 2009

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