Background: The prognosis after a curative resection for gastric cancer is modified by the lymph node involvement, while the prognostic significance of a microscopically-positive resection margin is debated. We systematically reviewed the literature from 1998 to 2013 to describe the role of surgery in the management of gastric cancer with a R1 after gastrectomy.
Materials and methods: The research was systematically performed on Pubmed, EMbase, Cochrane Library, CILEA Archive, BMJ Clinical Evidence and Up ToDate databases. Twelve studies were included in this review, for a total of 15,008 patients.
Results: The results reported in literature are inconsistent and the impact of surgical and oncological therapies is unknown. Intraoperative frozen sections should be performed to achieve a negative margin with intraoperative re-excision.
Conclusion: A surgical re-excision of an R1 resection should be considered for patients with fewer than three disease-positive nodes because survival is more likely to be governed by positive margins than by nodal status.
Keywords: Gastric cancer; R1; gastrectomy; microscopic residual disease; positive margins; resection line involvement.
Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.