Resection-line Involvement in Gastric Cancer Patients Undergoing Curative Resections: Implications for Clinical Management

BACKGROUND: Resection-line involvement has been suggested as an important prognostic factor for gastric cancer. METHODS: The relationship between resection-line involvement and outcome was examined in patients undergoing potentially curative resection for gastric cancer. RESULTS: Tumor positive resection-lines were seen in 22 of the 259 evaluable patients (8.4%). Resection-line involvement was associated with tumor location (P = 0.01) and tumor differentiation (P = 0.02). Positive margins were associated with worse survival. However, if both groups of patients are stratified according to lymph node metastases, resection-line involvement determined a shorter survival only in patients with N0 stage disease. CONCLUSIONS: Our data suggest, in the case of positive margins, that re-laparatomy should be considered only for patients with N0 stage disease, while patients with metastatic lymph nodes should be watched closely without the need for a more aggressive surgical approach.