Pathologic characteristics of residual carcinoma at incisal edge after gastrectomy for gastric cancer / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the reason, features and preventive measures of residual carcinoma at incisal edge after gastric cancer operation.</p><p><b>METHODS</b>Clinical data of 108 cases with positive incisal margin(6.47%) from December 1964 to December 2004 in Cancer Center of Sun Yat-sen were summarized and analyzed retrospectively.</p><p><b>RESULTS</b>Positive incisal margin patients accounted for 6.5%(108/1670) of total gastric carcinoma cases during above period. There were 62 men and 46 women with median age of 54 years(ranged from 23 to 82). The residual carcinoma rates of incisal edge were 3.6%(48/1333) in radical resection group and 17.8%(60/337) in palliative resection group respectively(P=0.000). Also, the residual carcinoma rates were 2.3%(3/129) in early group, 6.8(105/1541) in advanced group(P=0.046), 4.5%(37/815) in distal gastrectomy group and 8.0%(55/689) in proximal group respectively(P=0.000). Residual carcinomas were related with pTNM stage, Borrmann type, tumor size, differentiation and invasion depth(P<0.05).</p><p><b>CONCLUSIONS</b>Superior gastric carcinoma, Borrmann III(, IIII( type advanced cancer, tumor diameter > or =5 cm, poor differentiation or undifferentiated type and serosa invaded easily result in residual carcinoma at incisal edge. The radical preventive measure is to ensure that incisal edge ought to exceed 5 cm apart from the tumor.</p>