Retrospective Study
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World J Gastroenterol. Aug 14, 2014; 20(30): 10518-10524
Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10518
Length of negative resection margin does not affect local recurrence and survival in the patients with gastric cancer
Chang Min Lee, Ye Seob Jee, Ju-Hee Lee, Sang-Yong Son, Sang-Hoon Ahn, Do Joong Park, Hyung-Ho Kim
Chang Min Lee, Sang-Yong Son, Sang-Hoon Ahn, Do Joong Park, Hyung-Ho Kim, Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea
Do Joong Park, Hyung-Ho Kim, Colledge of Medicine, Seoul National University, Seoul 110-799, South Korea
Ye Seob Jee, Department of Surgery, Dankook University Hospital, Cheonan 330-715, South Korea
Ye Seob Jee, Colledge of Medicine, Dankook University, Cheonan 330-715, South Korea
Ju-Hee Lee, Department of Surgery, Hanyang University Medical Center, Seoul 133-792, South Korea
Author contributions: Lee CM and Kim HH designed the research; Son SY and Ahn SH performed the research; Jee YS, Lee JH and Park DJ contributed new analytic tools; Lee CM analyzed data and wrote the paper.
Correspondence to: Hyung-Ho Kim, MD, PhD, Department of Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon gil, Bundang-gu, Seongnam 463-707, South Korea. lapakh2@gmail.com
Telephone: +82-31-7877095 Fax: +82-31-7874078
Received: February 11, 2014
Revised: April 1, 2014
Accepted: May 23, 2014
Published online: August 14, 2014
Processing time: 187 Days and 23.1 Hours
Abstract

AIM: To investigate the influence of the resection margin on local recurrence and survival in gastric cancer patients.

METHODS: We reviewed the medical records of 1788 patients who had undergone gastrectomy for gastric cancer at the Seoul National University Bundang Hospital, South Korea, between May 2003 and July 2009. The patients were divided into early and advanced gastric cancer groups. In each group, we analyzed the relationship between clinicopathologic factors and survival outcomes, and compared the hazard rates of event occurrence between patients with resection margins above and below the cut-off value, using a Cox proportional hazard model.

RESULTS: The early and advanced gastric cancer groups included 1001 and 787 patients, respectively. The hazard rates of event occurrence did not significantly differ between the patients with resection margins above the cut-off value and those with resection margins below the cut-off value (P > 0.05, in all comparisons). Based on the multivariable analyses, the proximal and distal resection margins were not significantly associated with survival outcomes and local recurrence (P > 0.05, in all analyses).

CONCLUSION: The proximal or distal resection margins did not affect the prognosis of patients with gastric cancer if the margins were pathologically negative.

Keywords: Gastric cancer; Survival; Recurrence; Resection; Margin

Core tip: The correlation between the resection margin and survival outcomes was investigated in 1788 patients who had undergone curative surgery for gastric cancer. We found that the proximal or distal resection margins did not affect the prognosis of patients with gastric cancer if the margins were pathologically negative. Moreover, we believe that routine intraoperative frozen-section examination is important to confirm negative margins.