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POSITIVE PROXIMAL RESECTION MARGINS AFTER RESECTION FOR CARCINOMA OF THE OESOPHAGUS AND STOMACH: EFFECT ON SURVIVAL AND SYMPTOM RECURRENCE
Author(s) -
Gall C. A.,
Rieger N. A.,
Wattchow D. A.
Publication year - 1996
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1996.tb00732.x
Subject(s) - medicine , resection margin , surgery , dysphagia , thoracotomy , carcinoma , stage (stratigraphy) , stomach , resection , esophagus , retrospective cohort study , survival rate , paleontology , biology
Background: Our aim was to determine the frequency, survival and symptomatic local recurrence rate of patients with a positive proximal resection margin in a series of patients having a resection for carcinoma of the oesophagus or stomach. Methods: A retrospective study of pathology reports and case notes. Survival and data on local recurrence were obtained from the patient or general practitioner. Results: Ten (11.5%) of 87 patients having a gastric or oesophageal resection for carcinoma had a positive proximal resection margin. All 10 patients underwent a palliative resection for late‐stage disease. Nine were dead at an average 8.3 months (range 2–20 months) post‐resection and one patient remains alive at 9 months. Only one of these 10 patients had evidence of a local recurrence with recurrent dysphagia prior to death at 11 months. Conclusion: A high incidence of a positive proximal resection margin was found. This occurred in patients who underwent a palliative resection for late‐stage disease, most of whom died before local recurrence became a problem. For patients recognized as having late‐stage disease, surgery for symptom palliation need not be aggressive (such as to include a thoracotomy) because achieving microscopic clearance is unlikely to affect the long‐term outcome.