Introduction And Aims: Surgical resection with negative margins is part of the curative treatment of gastric adenocarcinoma. Positive surgical margins are associated with worse outcome. The aim of the present study was to determine the clinical usefulness of extending the proximal surgical margin in patients undergoing total gastrectomy for gastric adenocarcinoma.
Materials And Methods: A retrospective analysis of patients that underwent total gastrectomy within the time frame of 2002 and 2017 was conducted. Patients diagnosed with adenocarcinoma that underwent curative surgery were included. Patients were divided into three groups, depending on proximal surgical margin status: negative margin (R0), positive margin with additional resection to achieve negative margin (R1-R0), and positive margin (R1). Demographic and clinical variables were analyzed. The outcome measures to evaluate were recurrence, disease-free survival, and overall survival.
Results: Forty-eight patients were included in the study. Thirty-seven were classified as R0, 9 as R1-R0, and 2 as R1. Fifty-two percent of the patients had clinical stage III disease. The overall surgical mortality rate was 2% and the morbidity rate was higher than 29%. The local recurrence rate was 0% in the R1-R0 group vs. 50% in the R1 group (p = 0.02). Disease-free survival was 49 months in the R1-R0 group vs. 32 months in the R1 group (p = 0.6). Overall survival was 51 months for the R1-R0 group vs. 35 months for the R1 group (p = 0.5).
Conclusions: Intraoperative extension of the positive surgical margin improved the local recurrence rate but was not associated with improvement in overall survival or disease-free survival and could possibly increase postoperative morbidity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.rgmx.2018.03.006 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Surgical Approaches to Pre-Auricular Cutaneous Squamous Cell Carcinomas Extending to the Temporal Bone.
Head Neck
January 2025
Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, Queensland Skull Base Unit, Brisbane, Queensland, Australia.
Background: Standardized surgical approaches to advanced pre-auricular cutaneous squamous cell carcinomas (cSCC) are lacking.
Methods: Fifty-four patients who underwent lateral temporal bone resection (LTBR) for pre-auricular cSCC were grouped into "Levels" of increasing disease spread. Surgical approaches to achieve negative-margin resection were designed for each Level and replicated on cadaveric specimens.
Clinico-Pathological Significance of Tumor Infiltrating Immune Cells in Oral Squamous Cell Carcinoma-Hope or Hype?
Head Neck
January 2025
Department of Pathology, All India Institute of Medical Sciences, Rishikesh, India.
Background: To correlate between immunohistochemical expression of tumor-infiltrating lymphocytes (TILs), tumor-associated macrophages (TAMs), and natural killer (NK) cells with the AJCC 8th edition TNM staging system and other disease-modifying clinico-pathological variables.
Methods: The representative histology sections of tumor invasive margin (IM) and tumor core (TC) were selected according to the International Immuno-Oncology Biomarker Working Group and were subjected to immunohistochemistry with antibodies for TILs (CD3, CD8, FOXP3), NK Cells (CD57), TAMs (CD68, CD163) and pan-leukocyte marker (CD45). Histo-immuno-density-intensity (HIDI) scoring was calculated as a product of the proportion and intensity of staining.
Introduction: Sarcomas are rare cancers originating from mesenchymal tissues, manifesting in diverse anatomical locations, but notably in connective tissue, muscles and the skeleton. Thoracic sarcomas present a unique diagnostic and surgical challenge attributable to their rarity and pathoanatomy. Standard practice currently comprises wide surgical excision, often accompanied by adjuvant chemotherapy and/or radiotherapy.
View Article and Find Full Text PDFExternal validation of a multivariable prediction model for positive resection margins in breast-conserving surgery.
BMC Res Notes
January 2025
Department of Surgery, Department of Clinical Sciences, Division of Surgery, Skåne University Hospital, Lund University, Lund, Sweden.
Objectives: Positive resection margins after breast-conserving surgery (BCS) most often demands a repeat surgery. To preoperatively identify patients at risk of positive margins, a multivariable model has been developed that predicts positive margins after BCS with a high accuracy. This study aimed to externally validate this prediction model to explore its generalizability and assess if additional preoperatively available variables can further improve its predictive accuracy.
View Article and Find Full Text PDFGenAI synthesis of histopathological images from Raman imaging for intraoperative tongue squamous cell carcinoma assessment.
Int J Oral Sci
January 2025
School of Cyber Science and Engineering, Sichuan University, Chengdu, China.
The presence of a positive deep surgical margin in tongue squamous cell carcinoma (TSCC) significantly elevates the risk of local recurrence. Therefore, a prompt and precise intraoperative assessment of margin status is imperative to ensure thorough tumor resection. In this study, we integrate Raman imaging technology with an artificial intelligence (AI) generative model, proposing an innovative approach for intraoperative margin status diagnosis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!