Significato prognostico dell’interessamento dei margini di resezione dopo gastrectomia per carcinoma: esperienza monocentrica

Orsenigo, Elena and Tamburini, Andrea and Di Palo, Saverio and Nifosi, Jacopo and Kusamura, Sbigaki and Staudacher, Carlo (2009) Significato prognostico dell’interessamento dei margini di resezione dopo gastrectomia per carcinoma: esperienza monocentrica. Il giornale di chirurgia, 30 (5 Supp). p. 120. ISSN 1971-145X

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Curative gastrectomy represents the treatment of choice for gastric cancer. A variety of clinicopathologic features, such as resection line involvement (RLI) has been suggested as prognostic indicators for gastric cancer. The aim of this study was to investigate whether microscopic positive margins are detrimental to the outcome of gastric cancer patients treated with gastrectomy. Methods: Among 1087 consecutive patients who had undergone gastrectomy with curative intent for gastric cancer between January 1990 and December 2008, 116 patients (10,7%) had positive resection margins on final histology. Results: Among these 116 patients, 48 had proximal and distal involved margins, 33 had proximal involved margins, and 35 had distal involved margins. No one patient had reoperation. The mean distance between proximal gastric margin and the neoplasia was 4±3,8 (min 0, max 21) and from the distal margin and the neoplasia 4±3.9 (min 0, max 24). The negative margin group had a significantly longer median survival time (P <0.00001). When both groups of patients were stratified according to nodal stage, a positive resection margin determined a worse prognosis only in patients with node-positive disease (mean survival time: 63 months vs. 21 months, P = 0.0001). In early gastric cancer (EGC) the resection margin involvement did not influenced survival. On the contrary, in more advanced diseases the positive margins is a negative prognostic factor for survival. Conclusions: A positive gastric or oesophageal margin is an independent poor prognostic factor for long-term survival in stomach cancer in advanced disease or node positive patients.

Item Type: Article
Uncontrolled Keywords: Gastric cancer, resection margin, gastrectomy, prognosis
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Nadia Del Gobbo
Date Deposited: 11 Feb 2016 14:29
Last Modified: 11 Feb 2016 14:29

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