Appropriate Gastrectomy Resection Margins for Early Gastric Carcinoma

ObjectiveIn 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 DataThere are very few guidelines regarding the distance from the EGC tumor to the resection margins. MethodsWe 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 >30mm. ResultsThree of five patients demonstrating distances 1mm between the tumor and gross proximal margin were microscopically positive. No patients with gross proximal margins >1, 10, >10, or 30mm 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). ConclusionsWhen the resection margins are clear, we propose that margins >1mm are adequate for EGC gastrectomy. J. Surg. Oncol. 2014 109:198-201. (c) 2013 Wiley Periodicals, Inc.