title: Prognostic impact of microscopic positive margin in gastric cancer patients.
abstract: BACKGROUND
  Complete resection with negative surgical margins has been a long-held surgical philosophy based on the concept that even minimal remaining cancer cells will develop recurrences.
  
  
  OBJECTIVE
  This study investigated the clinical significance of microscopic positive margin on the outcome of patients with gastric cancers.
  
  
  METHODS
  The relationships between the margin status and other clinicopathologic factors were examined in gastric cancer patients undergoing gastrectomy, and then the prognostic impact of the margin status was evaluated by univariate and multivariate analysis.
  
  
  RESULTS
  The microscopic positive margin was identified in 23 patients (2.8%) by standard H&E staining. The positive margin showed a strong correlation significantly with tumor size (P < 0.05). Microscopic positive margin was found to be a significant prognostic factor on univariate analysis (5-year survival rate 51.9% vs. 82.2%, P < 0.0001), as well as multivariate analysis (risk ratio 3.24, 95% CI: 1.24-6.50, P < 0.01). Detailed analysis of margin status demonstrated that patients with positive margin in a deep site and/or in multiple layers showed poor survival.
  
  
  CONCLUSIONS
  Microscopic positive margin was found to be an independent prognostic factor in gastric cancer patients. The status of the surgical margin might provide useful information for selecting additional treatments and performing intensive follow-up.
authors: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
authors: Tomoyuki
authors: T
authors: Nagata
authors: Daisuke
authors: D
authors: Ichikawa
authors: Shuhei
authors: S
authors: Komatsu
authors: Koji
authors: K
authors: Inoue
authors: Atsushi
authors: A
authors: Shiozaki
authors: Hitoshi
authors: H
authors: Fujiwara
authors: Kazuma
authors: K
authors: Okamoto
authors: Chohei
authors: C
authors: Sakakura
authors: Eigo
authors: E
authors: Otsuji
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome