Background & objective: The resection boundary for gastric cancer is controversial. The study was designed to investigate gastric wall infiltration length of gastric cancer.
Methods: A total of 105 patients with gastric cancer who underwent gastrectomy at Cancer Center of Sun Yat-sen University from Apr. 2002 to Feb. 2004 were eligible. During gastrectomy, gastric wall lengths of 18 patients before traction (L1), after traction (L2), and after isolation (L3) were measured. Longitudinal specimen along the center of gastric cancer was fixed to measure the lengths of proximal and distal margins to the cancer. Giant section was observed under microscope to calculate the true infiltration length in proximal and distal margins according to the principle of the length changing uniformity.
Results: In the 18 specimens, L2 was significantly longer than L1 and L3 (P < 0.05); no significant difference was showed between L1 and L3 (P > 0.05). The infiltration length of localized gastric cancer, including early stage cancer, Borrmann I type cancer, and Borrmann II type cancer, was less than 2 cmû that of invasive gastric cancer, including Borrmann III type cancer and Borrmann IV type cancer, was less than 5 cm.
Conclusion: The resection length for localized gastric cancer is at least 2 cm to tumor margin, and for invasive gastric cancer is at least 5 cm to tumor margin.