Adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer: A systematic review and meta‐analysis

Abstract Aim A positive resection margin (RM) is associated with poor survival after gastrectomy for gastric cancer (GC). However, the adequate RM length to avoid a positive RM remains controversial. We performed a systematic review to examine the RM length required to avoid a positive RM in gastrec...

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Main Authors: Masaru Hayami, Manabu Ohashi, Nozomi Kurihara, Souya Nunobe
Format: Article
Language:English
Published: Wiley 2024-03-01
Series:Annals of Gastroenterological Surgery
Subjects:
Online Access:https://doi.org/10.1002/ags3.12761
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author Masaru Hayami
Manabu Ohashi
Nozomi Kurihara
Souya Nunobe
author_facet Masaru Hayami
Manabu Ohashi
Nozomi Kurihara
Souya Nunobe
author_sort Masaru Hayami
collection DOAJ
description Abstract Aim A positive resection margin (RM) is associated with poor survival after gastrectomy for gastric cancer (GC). However, the adequate RM length to avoid a positive RM remains controversial. We performed a systematic review to examine the RM length required to avoid a positive RM in gastrectomy for GC. Methods This systematic review involved all relevant articles identified in PubMed, the Cochrane Library, Web of Science, and ClinicalTrials.gov until August 2023. The incidence of a positive RM related to the RM length and the possible incidence of a positive RM estimated from the discrepancy between the gross and pathological RM length were evaluated. The Newcastle–Ottawa Scale was used to quantify study quality. Results Thirteen studies involving 8983 patients were analyzed. Investigation of the incidence of a positive RM in relation to the RM length showed that a proximal RM length of 6 cm guaranteed a negative RM in gastrectomy. Analyses of the possible incidence of a positive RM revealed that a negative RM would be guaranteed if the proximal RM length was 6 cm in distal gastrectomy, if the esophageal resection length was 2 cm in total gastrectomy for GC without esophageal invasion and 2.5 cm in total or proximal gastrectomy for GC with esophageal invasion or esophagogastric junction cancer, and if the distal RM length was 4 cm in proximal gastrectomy for early GC. Conclusions The adequate RM lengths to ensure a pathologically negative RM in each type of gastrectomy for GC were herein suggested.
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spelling doaj.art-16bb60f830ae46deaa6c08124c5fbcc52024-03-06T03:47:04ZengWileyAnnals of Gastroenterological Surgery2475-03282024-03-018220221310.1002/ags3.12761Adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer: A systematic review and meta‐analysisMasaru Hayami0Manabu Ohashi1Nozomi Kurihara2Souya Nunobe3Department of Gastroenterological Surgery, Gastroenterological Center Cancer Institute Hospital, Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery, Gastroenterological Center Cancer Institute Hospital, Japanese Foundation for Cancer Research Tokyo JapanDepartment of Clinical Trial Planning and Strategy Cancer Institute Hospital, Japanese Foundation for Cancer Research Tokyo JapanDepartment of Gastroenterological Surgery, Gastroenterological Center Cancer Institute Hospital, Japanese Foundation for Cancer Research Tokyo JapanAbstract Aim A positive resection margin (RM) is associated with poor survival after gastrectomy for gastric cancer (GC). However, the adequate RM length to avoid a positive RM remains controversial. We performed a systematic review to examine the RM length required to avoid a positive RM in gastrectomy for GC. Methods This systematic review involved all relevant articles identified in PubMed, the Cochrane Library, Web of Science, and ClinicalTrials.gov until August 2023. The incidence of a positive RM related to the RM length and the possible incidence of a positive RM estimated from the discrepancy between the gross and pathological RM length were evaluated. The Newcastle–Ottawa Scale was used to quantify study quality. Results Thirteen studies involving 8983 patients were analyzed. Investigation of the incidence of a positive RM in relation to the RM length showed that a proximal RM length of 6 cm guaranteed a negative RM in gastrectomy. Analyses of the possible incidence of a positive RM revealed that a negative RM would be guaranteed if the proximal RM length was 6 cm in distal gastrectomy, if the esophageal resection length was 2 cm in total gastrectomy for GC without esophageal invasion and 2.5 cm in total or proximal gastrectomy for GC with esophageal invasion or esophagogastric junction cancer, and if the distal RM length was 4 cm in proximal gastrectomy for early GC. Conclusions The adequate RM lengths to ensure a pathologically negative RM in each type of gastrectomy for GC were herein suggested.https://doi.org/10.1002/ags3.12761gastrectomygastric cancernegative resection marginpositive resection marginresection margin length
spellingShingle Masaru Hayami
Manabu Ohashi
Nozomi Kurihara
Souya Nunobe
Adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer: A systematic review and meta‐analysis
Annals of Gastroenterological Surgery
gastrectomy
gastric cancer
negative resection margin
positive resection margin
resection margin length
title Adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer: A systematic review and meta‐analysis
title_full Adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer: A systematic review and meta‐analysis
title_fullStr Adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer: A systematic review and meta‐analysis
title_full_unstemmed Adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer: A systematic review and meta‐analysis
title_short Adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer: A systematic review and meta‐analysis
title_sort adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer a systematic review and meta analysis
topic gastrectomy
gastric cancer
negative resection margin
positive resection margin
resection margin length
url https://doi.org/10.1002/ags3.12761
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