Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer
Objective:. To identify the minimum length of esophageal resection to ensure a pathologically negative proximal margin (PM) in total gastrectomy for gastric cancer. Background:. In total gastrectomy, a certain esophageal length is resected to obtain a pathologically negative PM because of the possib...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2022-03-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000127 |
| _version_ | 1797732795200569344 |
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| author | Yasufumi Koterazawa, MD, PhD Manabu Ohashi, MD, PhD Satoshi Hayami, MD, PhD Koshi Kumagai, MD, PhD Takeshi Sano, MD, PhD Souya Nunobe, MD, PhD |
| author_facet | Yasufumi Koterazawa, MD, PhD Manabu Ohashi, MD, PhD Satoshi Hayami, MD, PhD Koshi Kumagai, MD, PhD Takeshi Sano, MD, PhD Souya Nunobe, MD, PhD |
| author_sort | Yasufumi Koterazawa, MD, PhD |
| collection | DOAJ |
| description | Objective:. To identify the minimum length of esophageal resection to ensure a pathologically negative proximal margin (PM) in total gastrectomy for gastric cancer.
Background:. In total gastrectomy, a certain esophageal length is resected to obtain a pathologically negative PM because of the possibility of unexpected pathological esophageal invasion. However, a recommendation regarding the esophageal transection site in total gastrectomy has not been established.
Methods:. The data of patients who underwent total gastrectomy for gastric cancer from 2005 to 2018 were collected. We evaluated the length of unexpected pathological esophageal invasion (esophageal ΔPM) in each type of disease and each location of the gross proximal tumor boundary (PB) using the length between the PB and the esophagogastric junction (PB-EGJ length).
Results:. Of the 1005 patients eligible for this study, 277, 196, and 532 had cT1, cT2–4 expansive (Exp), and cT2–4 infiltrative (Inf) growth patterns, respectively. In cT1 and Exp, no unexpected pathological esophageal invasion occurred when the PB-EGJ length was >1 cm, whereas pathological esophageal invasion occurred in 20.0% of cT1 and 32.7% of Exp when the PB-EGJ length was ≤1 cm. The esophageal ΔPM was <1 cm. In Inf, no unexpected pathological esophageal invasion occurred when the PB-EGJ length was >3 cm, whereas pathological esophageal invasion occurred in 17.4% of patients when the PB-EGJ length was ≤3 cm. The esophageal ΔPM was <2 cm.
Conclusions:. New recommendations regarding the esophageal resection length required to ensure a pathologically negative PM in total gastrectomy are herein proposed. |
| first_indexed | 2024-03-12T12:19:42Z |
| format | Article |
| id | doaj.art-71a645033d184d4dbc91de0999f5d7ef |
| institution | Directory Open Access Journal |
| issn | 2691-3593 |
| language | English |
| last_indexed | 2024-03-12T12:19:42Z |
| publishDate | 2022-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj.art-71a645033d184d4dbc91de0999f5d7ef2023-08-30T06:09:42ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932022-03-0131e12710.1097/AS9.0000000000000127202203000-00011Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric CancerYasufumi Koterazawa, MD, PhD0Manabu Ohashi, MD, PhD1Satoshi Hayami, MD, PhD2Koshi Kumagai, MD, PhD3Takeshi Sano, MD, PhD4Souya Nunobe, MD, PhD5From the Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.From the Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.From the Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.From the Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.From the Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.From the Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.Objective:. To identify the minimum length of esophageal resection to ensure a pathologically negative proximal margin (PM) in total gastrectomy for gastric cancer. Background:. In total gastrectomy, a certain esophageal length is resected to obtain a pathologically negative PM because of the possibility of unexpected pathological esophageal invasion. However, a recommendation regarding the esophageal transection site in total gastrectomy has not been established. Methods:. The data of patients who underwent total gastrectomy for gastric cancer from 2005 to 2018 were collected. We evaluated the length of unexpected pathological esophageal invasion (esophageal ΔPM) in each type of disease and each location of the gross proximal tumor boundary (PB) using the length between the PB and the esophagogastric junction (PB-EGJ length). Results:. Of the 1005 patients eligible for this study, 277, 196, and 532 had cT1, cT2–4 expansive (Exp), and cT2–4 infiltrative (Inf) growth patterns, respectively. In cT1 and Exp, no unexpected pathological esophageal invasion occurred when the PB-EGJ length was >1 cm, whereas pathological esophageal invasion occurred in 20.0% of cT1 and 32.7% of Exp when the PB-EGJ length was ≤1 cm. The esophageal ΔPM was <1 cm. In Inf, no unexpected pathological esophageal invasion occurred when the PB-EGJ length was >3 cm, whereas pathological esophageal invasion occurred in 17.4% of patients when the PB-EGJ length was ≤3 cm. The esophageal ΔPM was <2 cm. Conclusions:. New recommendations regarding the esophageal resection length required to ensure a pathologically negative PM in total gastrectomy are herein proposed.http://journals.lww.com/10.1097/AS9.0000000000000127 |
| spellingShingle | Yasufumi Koterazawa, MD, PhD Manabu Ohashi, MD, PhD Satoshi Hayami, MD, PhD Koshi Kumagai, MD, PhD Takeshi Sano, MD, PhD Souya Nunobe, MD, PhD Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer Annals of Surgery Open |
| title | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer |
| title_full | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer |
| title_fullStr | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer |
| title_full_unstemmed | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer |
| title_short | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer |
| title_sort | minimum esophageal resection length to ensure negative proximal margin in total gastrectomy for gastric cancer |
| url | http://journals.lww.com/10.1097/AS9.0000000000000127 |
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