Does Resection Line Involvement Affect Prognosis in Early Gastric Cancer Patients? An Italian Multicentric Study

Does Resection Line Involvement Affect Prognosis in Early Gastric Cancer Patients? An Italian Multicentric Study

Background Resection line involvement has been indicated as an important prognostic factor for gastric cancer. Its late detection renders the choice of treatment difficult for surgeons. Materials and Methods We describe the multicenter experience of a group of 11 patients with early gastric carcinom...

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Bibliographic Details
Published in:World journal of surgery Vol. 30; no. 4; pp. 585 - 589
Main Authors: Morgagni, Paolo, Garcea, Domenico, Marrelli, Daniele, de Manzoni, Giovanni, Natalini, Giovanni, Kurihara, Hayato, Marchet, Alberto, Vittimberga, Giovanni, Saragoni, Luca, Roviello, Franco, Leo, Alberto Di, De Santis, Francesco, Panizza, Valerio, Nitti, Donato
Format: Journal Article
Language:English
Published: New York Springer‐Verlag 01-04-2006
Springer
Springer Nature B.V
Subjects:
Adult
Biological and medical sciences
Cancer
Complications
Duodenum - pathology
Duodenum - surgery
Early Gastric Cancer
Female
Gastrectomy - methods
Gastric Cancer
Gastric Cancer Patient
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Humans
Lymph Node Excision
Lymph nodes
Lymphatic Metastasis
Macroscopic Type
Male
Medical prognosis
Medical sciences
Metastases
Middle Aged
Neoplasm Staging
Neoplasm, Residual - mortality
Neoplasm, Residual - pathology
Patients
Postoperative Complications - mortality
Postoperative Complications - pathology
Prognosis
Resection Line
Stomach - pathology
Stomach Neoplasms - mortality
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Survival Rate
Tumors
Italy
Europe
Human
Prognosis
Multicenter study
Patient
Surgical resection
Malignant tumor
Stomach cancer
Medicine
Treatment
Surgery
Digestive diseases
Early
Gastric disease
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Summary:Background Resection line involvement has been indicated as an important prognostic factor for gastric cancer. Its late detection renders the choice of treatment difficult for surgeons. Materials and Methods We describe the multicenter experience of a group of 11 patients with early gastric carcinoma (EGC) and positive resection confirmed at histological examination who did not undergo surgical retreatment for reasons of associated disease, surgical considerations on duodenal stump, or patient refusal. Results The gastric margin was involved in 4 patients, and 7 patients had duodenal resection line involvement. No surgical complications or postoperative deaths were observed. Five and 8‐year survival was 100% and 86%, respectively. The only patient who relapsed did not have lymph node involvement and died from liver metastases, without local recurrence. Conclusions It is sometimes difficult to accurately define the resection line in gastric cancer surgery, especially in the early stages of disease, but because of the strongly negative prognostic value of an infiltrated margin, frozen sections are recommended if neoplastic invasion is suspected and a new resection is always recommended if possible. Nevertheless, the good prognosis of resected EGC patients with resection line involvement must be considered before submitting patients with associated diseases to radical surgical retreatment.
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ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-005-7975-x