Prognostic impact of resection margin involvement after extended (D2/D3) gastrectomy for advanced gastric cancer

A 15-year experience at a single Institute

ByoungChul Cho, Cheul Jeung Hei, Jin Choi Hye, SunYoung Rha, WooJin Hyung, H. Cheong Jae, Hoon Noh Sung, Hyuncheol Chung

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Pages (from-to)461-468
Number of pages8
JournalJournal of Surgical Oncology
Volume95
Issue number6
DOIs
Publication statusPublished - 2007 May 1

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Gastrectomy
Stomach Neoplasms
Survival
Margins of Excision
Histology
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

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title = "Prognostic impact of resection margin involvement after extended (D2/D3) gastrectomy for advanced gastric cancer: A 15-year experience at a single Institute",
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.",
author = "ByoungChul Cho and Hei, {Cheul Jeung} and Hye, {Jin Choi} and SunYoung Rha and WooJin Hyung and Jae, {H. Cheong} and Sung, {Hoon Noh} and Hyuncheol Chung",
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Prognostic impact of resection margin involvement after extended (D2/D3) gastrectomy for advanced gastric cancer : A 15-year experience at a single Institute. / Cho, ByoungChul; Hei, Cheul Jeung; Hye, Jin Choi; Rha, SunYoung; Hyung, WooJin; Jae, H. Cheong; Sung, Hoon Noh; Chung, Hyuncheol.

In: Journal of Surgical Oncology, Vol. 95, No. 6, 01.05.2007, p. 461-468.

Research output: Contribution to journalArticle

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AU - Sung, Hoon Noh

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