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Individualized proximal margin correlates with outcomes in gastric cancers with radical gastrectomy.

Abstract The length of proximal margin for gastrectomy remains controversial. The proximal margin and its relationships with clinicopathological variables and overall survival of 922 gastric cancers were retrospectively analyzed. Proximal margin was divided into four groups (0-2.0, 2.1-4.0, 4.1-6.0, and >6.0 cm). It indicated that the overall survival was improved with the increase of proximal margin. The proximal margin of 2.1-4.0 cm was associated with a better overall survival for gastric cancers with solitary-type (T1 and T2 stages, N0 stage, tumor-node-metastasis stages I and II, tumor size <5 cm, histological G1 and G2, and Bormann type I and II). Futhermore, proximal margin of 4.1-6.0 cm was associated with a better overall survival for gastric cancers with infiltrative-type (T3 and T4 stages, N1 stage, tumor-node-metastasis stage III, tumor size ⩾5 cm, histological G3 and G4, and Bormann type III and IV). Univariate analysis revealed that T stage, N stage, tumor-node-metastasis stage, histological grade, Bormann type, carcinoembryonic antigen, carbohydrate antigen 199, extent of gastrectomy, tumor location, and proximal margin were significantly associated with overall survival. Multivariate analysis revealed that tumor-node-metastasis stage, histological grade, Bormann type, carcinoembryonic antigen, carbohydrate antigen 199, extent of gastrectomy, and proximal margin were independent prognostic factors for gastric cancers with radical gastrectomy. In conclusion, the proximal margin was an independent prognostic factor for gastric cancer and should be decided individually. Proximal margin of 2.1-4.0 cm and 4.1-6.0 cm were needed for patients with solitary-type and infiltrative-type, respectively.
PMID
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Authors

Mayor MeshTerms

Gastrectomy

Lymph Node Excision

Prognosis

Keywords

Gastric cancer

clinicopathological variables

individualized resection

prognosis

proximal margin

Journal Title tumour biology : the journal of the international society for oncodevelopmental biology and medicine
Publication Year Start




PMID- 28639911
OWN - NLM
STAT- MEDLINE
DA  - 20170622
DCOM- 20170711
LR  - 20170713
IS  - 1423-0380 (Electronic)
IS  - 1010-4283 (Linking)
VI  - 39
IP  - 6
DP  - 2017 Jun
TI  - Individualized proximal margin correlates with outcomes in gastric cancers with
      radical gastrectomy.
PG  - 1010428317711032
LID - 10.1177/1010428317711032 [doi]
AB  - The length of proximal margin for gastrectomy remains controversial. The proximal
      margin and its relationships with clinicopathological variables and overall
      survival of 922 gastric cancers were retrospectively analyzed. Proximal margin
      was divided into four groups (0-2.0, 2.1-4.0, 4.1-6.0, and &gt;6.0 cm). It indicated
      that the overall survival was improved with the increase of proximal margin. The 
      proximal margin of 2.1-4.0 cm was associated with a better overall survival for
      gastric cancers with solitary-type (T1 and T2 stages, N0 stage,
      tumor-node-metastasis stages I and II, tumor size &lt;5 cm, histological G1 and G2, 
      and Bormann type I and II). Futhermore, proximal margin of 4.1-6.0 cm was
      associated with a better overall survival for gastric cancers with
      infiltrative-type (T3 and T4 stages, N1 stage, tumor-node-metastasis stage III,
      tumor size 5 cm, histological G3 and G4, and Bormann type III and IV). Univariate
      analysis revealed that T stage, N stage, tumor-node-metastasis stage,
      histological grade, Bormann type, carcinoembryonic antigen, carbohydrate antigen 
      199, extent of gastrectomy, tumor location, and proximal margin were
      significantly associated with overall survival. Multivariate analysis revealed
      that tumor-node-metastasis stage, histological grade, Bormann type,
      carcinoembryonic antigen, carbohydrate antigen 199, extent of gastrectomy, and
      proximal margin were independent prognostic factors for gastric cancers with
      radical gastrectomy. In conclusion, the proximal margin was an independent
      prognostic factor for gastric cancer and should be decided individually. Proximal
      margin of 2.1-4.0 cm and 4.1-6.0 cm were needed for patients with solitary-type
      and infiltrative-type, respectively.
FAU - Wang, Junfeng
AU  - Wang J
AD  - Department of Colorectal Cancer, Tianjin Medical University Cancer Institute and 
      Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, National
      Clinical Research Center of Cancer, Tianjin, China.
FAU - Liu, Jianzhong
AU  - Liu J
AD  - Department of Colorectal Cancer, Tianjin Medical University Cancer Institute and 
      Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, National
      Clinical Research Center of Cancer, Tianjin, China.
FAU - Zhang, Gaojia
AU  - Zhang G
AD  - Department of Colorectal Cancer, Tianjin Medical University Cancer Institute and 
      Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, National
      Clinical Research Center of Cancer, Tianjin, China.
FAU - Kong, Dalu
AU  - Kong D
AD  - Department of Colorectal Cancer, Tianjin Medical University Cancer Institute and 
      Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, National
      Clinical Research Center of Cancer, Tianjin, China.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Tumour Biol
JT  - Tumour biology : the journal of the International Society for Oncodevelopmental
      Biology and Medicine
JID - 8409922
RN  - 0 (Antigens, Tumor-Associated, Carbohydrate)
RN  - 0 (carbohydrate antigen 199, human)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antigens, Tumor-Associated, Carbohydrate/genetics
MH  - Disease-Free Survival
MH  - Female
MH  - *Gastrectomy
MH  - Humans
MH  - *Lymph Node Excision
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - *Prognosis
MH  - Stomach Neoplasms/pathology/*surgery
OTO - NOTNLM
OT  - Gastric cancer
OT  - clinicopathological variables
OT  - individualized resection
OT  - prognosis
OT  - proximal margin
EDAT- 2017/06/24 06:00
MHDA- 2017/07/14 06:00
CRDT- 2017/06/23 06:00
AID - 10.1177/1010428317711032 [doi]
PST - ppublish
SO  - Tumour Biol. 2017 Jun;39(6):1010428317711032. doi: 10.1177/1010428317711032.