Resection-line involvement in gastric cancer patients undergoing curative resections: implications for clinical management.

Background: Resection-line involvement has beensuggested as an important prognostic factor for gastriccancer. 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 wasassociated withtumorlocation (P= 0.01) andtumordifferentiation (P = 0.02). Positive margins were associated with worse survival. However, if both groups of patients arestratifed according to lymph nodemetastases, resection-line involvement determined a shortersurvival only in patients with NO stage disease. Conclusions: Our data suggest, in the case of positive margins, that re-Iaparatomy should be considered only for patients with NO stage disease, while patients with metastatic lymph nodes should be watched closely without the need for a moreaggressive surgical approach.