Abstract
The margins of the surgically resected gastric specimen are distinguished as proximal and distal, while deep and lateral margins are determined only after endoscopic resection. Several clinicopathological features of the tumor have been reported as risk factors for resection margin involvement. The most important of these is poorly differentiated carcinoma, large size of the tumor (minimum diameter > 5 cm), and macroscopic Borrmann’s type III or IV. The diffusion of the disease is related to the primary tumor site and differences exist between the esophageal and duodenal margins. In the resected specimen, the distance from the tumor and the resection margins must always be checked by the surgeon, and frozen sections are required when infiltration is suspected. When the resection margins are infiltrated, patients must be re-treated to achieve radical resection whenever possible, except in cases of very advanced cancer. Based on the good prognosis of some early gastric cancers, age and associated diseases also must be taken into consideration before proposing a second treatment in these patients.
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Cunningham SC, Kamangar F, Kim MP et al (2005) Survival after gastric adenocarcinoma resection: eighteen-year experience at a single institution. J Gastrointest Surg 9:718–725
Cho BC, Jeung HC, Choi HJ et al (2007) Prognostic impact of resection margin involvement advanced gastric cancer: a 15-year experience at a single institute. J Surg Oncol 95:461–468
De Gara CJ, Hanson J, Hamilton S (2003) A populationbased study of tumor-node relationship, resection margins, and surgeon volume on gastric cancer survival. Am J Surg 186:23–27
Kim SH, Karpeh MS, Klimstra DS et al (1999) Effect of microscopic resection line disease on gastric cancer survival. J Gastrointest Surg 3:24–33
Sobin LH, Wittekind CH (2002) TNM classification of malignant tumor, 6th edn. Wiley, New York
Park JM, Jang YJ, Kim JH et al (2008) Gastric cancer histology: clinicopathologic characteristics and prognostic value. J Surg Oncol 98:520–525
Piessen G, PhD, Messager M, Leteurtre E et al (2009) Signet ring cell histology is an indipendent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg 250:878–887
Yokota T, Sawai K, Yamaguchi T et al (1993) Resection margin in patients with gastric cancer associated with esophageal invasion: clinicopathological study. J Surg Oncol 53:60–63
Zhe S, De-ming L, Zhen-ning W et al (2009) Prognostic significance of microscopic positive margins for gastric cancer patients with potentially curative resection. Ann Surg Oncol 16:3028–3037
Shang-Yu W, Chun-Nan Y, Hsiang-Lin L et al (2009) Clinical Impact of positive surgical margin status on gastric cancer patients undergoing gastrectomy. Surg Oncol 16:2738–2743
Bozzetti F, Bonfanti G, Bufalino R et al (1982) Adequacy of margins of resection in gastrectomy for cancer. Ann Surg 196:685–690
Tsujitani S, Okuyama T, Orita H et al (1995) Margins of resection of the esophagous for gastric cancer with esophageal invasion. Hepatogastroenterology 42:873–877
Kakeji Y, Tsujitani S, Baba H et al (1991) Clinicopathologic features and prognostic significance of duodenal invasion in patients with distal gastric carcinoma. Cancer 68:380–384
Yokota T, Yamaguchi T, Sawai K et al (1989) Intraoperative immunostaining for detection of invasive cells at the resection margin of Borrmann type 4 gastric carcinoma using monoclonal antibody S202. Br J Surg 76:690–692
Morgagni P, Garcea D, Marrelli D et al (2008) Resection line involvement after gastric cancer surgery: clinical outcome in nonsurgically retreated patients. World J Surg 32:2661–2667
Cascinu S, Giordani P, Catalano V et al (1999) Resection line involvement in gastric cancer patients undergoing curative resections: Implication for clinical management. Jpn J Clin Oncol 29:291–293
Morgagni P, Garcea D, Marrelli D et al (2006) Does resection line involvement affect prognosis in early gastric cancer patients? An Italian multicentric study. World J Surg 30:585–589
Nakamura K, Ueyama T, Yao T et al (1992) Pathology and prognosis of gastric cancer: Findings in 10,000 patients who underwent primary gastrectomy. Cancer 70:1030–1037
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Morgagni, P., La Barba, G., Saragoni, L. (2012). Resection Margins in Gastric Cancer. In: de Manzoni, G., Roviello, F., Siquini, W. (eds) Surgery in the Multimodal Management of Gastric Cancer. Springer, Milano. https://doi.org/10.1007/978-88-470-2318-5_8
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DOI: https://doi.org/10.1007/978-88-470-2318-5_8
Publisher Name: Springer, Milano
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