Studies on Oral Margin in Gastric Cancer from the Standpoint of Discrepancy between Macroscopic and Histological Measurement of Invasion

Kuniyoshi Arai, Masatsugu Kitamura, Kaoru Miyashita

Department of Surgery, Tokyo Metropolitan Komagome Hospital

The distance of discrepancy (DD) between macroscopic and histological measurement of the oral margin in gastric cancer was clinico-pathologically examined. The subjects were 248 patients with advanced gastric cancer, on whom a curative operation had been performed more than 5 years earlier. The DDs of these cases were compared according to depth, histological type and macroscopic type of the main lesion. The results showed that misdiagnosis was mostly related to the macroscopic type, and the DD of the infiltrative type was statistically larger than that of the localized type in underestimated cases (p<0.05). As for background, the rates of stage 3, scirrhous growth pattern and INFγ were higher in the infiltrative type, whereas no difference was seen in the factors of lymphatic permeation, venous invasion and tumor size. In contrast with a DD of less than 9 mm in 93.3% of the cases of the localized type, a DD of 19 mm was required for the infiltrative type to attain the same rate. In conclusion, more care should be taken about the cutting line of gastrectomy in the infiltrative type of cancer.

Key words
distance of oral margin in gastric cancer, discrepancy between macroscopic and histological measurement of invasion, underestimation of oral invasion, infiltrative gastrci cancer

Reprint requests
Kuniyoshi Arai Department of Surgery, Tokyo Metropolitan Komagome Hospital
3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
October 7, 1992

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