Objective: In Korea and Japan, early gastric cancer (EGC) accounts for >50% of all gastric cancers. Here, we propose recommendations for the optimal distance from the tumor to the resection margins when evaluating EGC.
Summary of background data: There are very few guidelines regarding the distance from the EGC tumor to the resection margins.
Methods: We evaluated 2,081 patients who underwent gastrectomy for EGC between January 1989 and May 2000. We subdivided tumors according to the distance from the proximal margin: ≤ 1, >1, ≤ 10, >10, ≤ 30, or >30 mm.
Results: Three of five patients demonstrating distances ≤ 1 mm between the tumor and gross proximal margin were microscopically positive. No patients with gross proximal margins >1, ≤ 10, >10, or ≤ 30 mm were microscopically positive. There were no statistical differences in rates of microscopically positive margin, reresection, or reoperation between groups (P > 0.05). In addition, there were statistical differences in terms of tumor recurrence and disease-related death between groups (P > 0.05).
Conclusions: When the resection margins are clear, we propose that margins >1 mm are adequate for EGC gastrectomy.
Keywords: early gastric cancer; reresection; resection margin.
© 2013 Wiley Periodicals, Inc.