Optimal proximal resection margin distance for gastrectomy in advanced gastric cancer

作     者：Amy Kim Beom Su Kim Jeong Hwan Yook Byung Sik Kim 

作者机构：Division of Stomach SurgeryDepartment of SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea Department of SurgeryKorea University Medical Center Ansan HospitalAnsanGyeonggi-do 15355South Korea 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2020年第26卷第18期

页      面：2232-2246页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100214[医学-肿瘤学] 10[医学] 

主　　题：Stomach neoplasms Gastrectomy Margins of excision Prognosis Recurrence 

摘      要：BACKGROUND The conventional guidelines to obtain a safe proximal resection margin(PRM)of5-6 cm during advanced gastric cancer(AGC)surgery are still applied by many surgeons across the *** recent studies have raised questions regarding the need for such extensive resection,but without reaching *** study was designed to prove that the PRM distance does not affect the prognosis of patients who undergo gastrectomy for *** To investigate the influence of the PRM distance on the prognosis of patients who underwent gastrectomy for *** Electronic medical records of 1518 patients who underwent curative gastrectomy for AGC between June 2004 and December 2007 at Asan Medical Center,a tertiary care center in Korea,were reviewed retrospectively for the *** demographics and clinicopathologic outcomes were compared between patients who underwent surgery with different PRM distances using one-way ANOVA and Fisher’s exact test for continuous and categorical variables,*** influence of PRM on recurrence-free survival and overall survival were analyzed using Kaplan-Meier survival analysis and Cox proportional hazard *** The median PRM distance was 4.8 cm and 3.5 cm in the distal gastrectomy(DG)and total gastrectomy(TG)groups,*** cohorts in the DG and TG groups were subdivided into different groups according to the PRM distance;≤1.0 cm,1.1-3.0 cm,3.1-5.0 cm and5.0 *** DG and TG groups showed nostatistical difference in recurrence rate(23.5%vs 30.6%vs 24.0%vs 24.7%,P=0.765)or local recurrence rate(5.9%vs 6.5%vs 8.4%vs 6.2%,P=0.727)according to the distance of *** both groups,Kalpan-Meier analysis showed no statistical difference in recurrence-free survival(P=0.467 in DG group;P=0.155 in TG group)or overall survival(P=0.503 in DG group;P=0.155 in TG group)according to the PRM *** analysis using Cox proportional hazard model revealed that in both groups,there was no significant differ