title: [Prognostic effect of postoperative resection-margin status for intraoperative positive resection margins in patients with advanced gastric cancer].
abstract: OBJECTIVE
  To investigate prognostic effect of postoperative resection-margin status for intraoperatively positive resection margin in advanced gastric cancer and discuss the treatment choice for intraoperatively positive resection margins.
  
  
  METHODS
  A retrospective study was investigated in 64 advanced gastric cancer patients with positive resection margin after potentially curative resection. The survival between 50 patients who was re-excised to a negative resection margin (NR group) and 14 patients who were left with positive resection margin (PR group) was compared. Prognostic factors were analyzed using univariate and multivariate Cox regression model analysis.
  
  
  RESULTS
  The median survival in the PR group was 17.0 months (95%CI: 11.6 - 22.4) as compared with 23.0 months (95%CI: 20.5 - 25.5) in the NR group (P = 0.045). However, resection-margin status lost significance on multivariate analysis. In the subgroup of D2 lymphadenectomy, the median survival in the PR group and NR group were 17.0 months (95%CI: 12.0 - 22.0) and 24.0 months (95%CI: 19.8 - 28.1) respectively; multivariate analysis further identified resection margin status as an independent prognostic factor.
  
  
  CONCLUSIONS
  Re-excision for intraoperatively positive margin to negative margin improves the prognosis of the patients with advanced gastric cancer, and re-excision is the first choice when intraoperative frozen section detects a positive margin. Routine frozen section of resection margin should be mandatory in all advanced gastric cancer undergoing potentially curative surgery.
authors.affiliation: Department of Surgical Oncology, Zhejiang University, Hangzhou, China.
authors.forename: Ji-da
authors.initials: JD
authors.lastname: Chen
authors.forename: Xiao-ming
authors.initials: XM
authors.lastname: Yuan
authors.forename: Wen-Jun
authors.initials: WJ
authors.lastname: Chen
authors.forename: Tao
authors.initials: T
authors.lastname: Pan
authors.forename: Jian-guo
authors.initials: JG
authors.lastname: Shen
authors.forename: Wen-xian
authors.initials: WX
authors.lastname: Hu
authors.forename: Lin-bo
authors.initials: LB
authors.lastname: Wang
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*