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Prognostic value of surgical margin status in gastric cancer patients
Author(s) -
Liang Yuexiang,
Ding Xuewei,
Wang Xiaona,
Wang Baogui,
Deng Jingyu,
Zhang Li,
Liang Han
Publication year - 2015
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12515
Subject(s) - medicine , surgical margin , gastrectomy , resection margin , stage (stratigraphy) , multivariate analysis , cancer , margin (machine learning) , proportional hazards model , surgery , chemotherapy , oncology , resection , paleontology , machine learning , computer science , biology
Background It has been reported that positive surgical margin is one of the most significant risk factors for local recurrence and poor survival. However, the survival of gastric cancer ( GC ) patients with positive margin is still controversial. Methods A total of 1025 stage I – III GC patients who underwent gastrectomy with curative intent between J anuary 2003 and A pril 2008 in our centre were enrolled in this study, of whom, 75 patients got a microscopic positive resection margin. Other 950 patients with negative resection margin were used for comparison. Results Borrmann type and extranodal metastasis were independent risk factors for positive margin. The 5‐year overall survival for the patients with positive margin is merely 13.3%. Survival in such patients was similar to that of the patients staged IIIc with R 0 resection. In multivariate analysis, surgical margin status was found to be an independent prognostic factor for GC patients, while histology, tumour location, TNM stage and chemotherapy were independently associated with overall survival for patients with positive margin. Conclusion Surgical margin status is an independent prognostic factor for GC . Patients with positive margin have a poor prognosis, similar to that of IIIc stage disease. When the tumour demonstrates infiltrative growth pattern ( B orrmann type III and IV ) and the surgical margin status is difficult to determine, extended gastrectomy should be implemented to ensure an R 0 resection. Those high‐risk patients should be considered for postoperative chemotherapy.