Lee Chang Min, Jee Ye Seob, Lee Ju-Hee, Son Sang-Yong, Ahn Sang-Hoon, Park Do Joong, Kim Hyung-Ho
Chang Min Lee, Sang-Yong Son, Sang-Hoon Ahn, Do Joong Park, Hyung-Ho Kim, Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea.
World J Gastroenterol. 2014 Aug 14;20(30):10518-24. doi: 10.3748/wjg.v20.i30.10518.
To investigate the influence of the resection margin on local recurrence and survival in gastric cancer patients.
We reviewed the medical records of 1788 patients who had undergone gastrectomy for gastric cancer at the Seoul National University Bundang Hospital, South Korea, between May 2003 and July 2009. The patients were divided into early and advanced gastric cancer groups. In each group, we analyzed the relationship between clinicopathologic factors and survival outcomes, and compared the hazard rates of event occurrence between patients with resection margins above and below the cut-off value, using a Cox proportional hazard model.
The early and advanced gastric cancer groups included 1001 and 787 patients, respectively. The hazard rates of event occurrence did not significantly differ between the patients with resection margins above the cut-off value and those with resection margins below the cut-off value (P > 0.05, in all comparisons). Based on the multivariable analyses, the proximal and distal resection margins were not significantly associated with survival outcomes and local recurrence (P > 0.05, in all analyses).
The proximal or distal resection margins did not affect the prognosis of patients with gastric cancer if the margins were pathologically negative.
探讨切缘对胃癌患者局部复发及生存的影响。
我们回顾了2003年5月至2009年7月期间在韩国首尔国立大学盆唐医院接受胃癌胃切除术的1788例患者的病历。患者被分为早期胃癌组和进展期胃癌组。在每组中,我们分析了临床病理因素与生存结局之间的关系,并使用Cox比例风险模型比较了切缘高于和低于临界值的患者事件发生的风险率。
早期胃癌组和进展期胃癌组分别包括1001例和787例患者。切缘高于临界值的患者与切缘低于临界值的患者事件发生的风险率无显著差异(所有比较中P>0.05)。基于多变量分析,近端和远端切缘与生存结局及局部复发无显著相关性(所有分析中P>0.05)。
如果切缘病理检查为阴性,近端或远端切缘不影响胃癌患者的预后。