Resection-line involvement in gastric cancer patients undergoing curative resections: implications for clinical management.
BACKGROUND
Resection-line involvement has been suggested as an important prognostic factor for gastric cancer.


METHODS
The relationship between resection-line involvement and outcome was examined in patients undergoing potentially curative resection for gastric cancer.


RESULTS
Tumor positive resection-lines were seen in 22 of the 259 evaluable patients (8.4%). Resection-line involvement was associated with tumor location (P = 0.01) and tumor differentiation (P = 0.02). Positive margins were associated with worse survival. However, if both groups of patients are stratified according to lymph node metastases, resection-line involvement determined a shorter survival only in patients with N0 stage disease.


CONCLUSIONS
Our data suggest, in the case of positive margins, that re-laparatomy should be considered only for patients with N0 stage disease, while patients with metastatic lymph nodes should be watched closely without the need for a more aggressive surgical approach.
Cascinu
S
S
Division of Medical Oncology, Azienda Ospedaliera Ospedale S. Salvatore, Pesaro, Italy. cascinu@yahoo.com
Giordani
P
P
Catalano
V
V
Agostinelli
R
R
Catalano
G
G
D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007813:Laparotomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012086:Reoperation; D013270:Stomach / Q000473:pathology / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome