A Clinical Study on Intraoperative Additional Resection for Gastric Cancer with Residual Cancer Cell in the Surgical Margin

Yoshihiro Moriwaki, Ken Yamanaka, Kazutaka Koganei, Hiroyuki Kure, Takuya Kudo, Syuhei Morita

Department of Surgery, Yokohama Red Cross Hospital

We evaluated the prognosis of 14 patients with invasive gastric cancer who were possibly exposed to cancer cells because of additional intraoperative resection for histopathological evidence of cancer cells at the surgical margin (Group A). The control group consisted of 197 invasive gastric cancer patients, with or without additional resection and without cancer cells at the surgical margin (Group C). In group A, 4 patients without serosal invasion (PS negative) remained disease free during follow up. The five year survival rate and the five year disease free rate of 10 patients with serosal invasion (PS positive) was 33.3% and 13.0%. These rate were not statistically different from those of patients in group C (30.6 and 23.2%). Considering the degree of node metastasis, there is no significance between 2 groups. Compereing the survival rate and disease free rate divided into stage (The General Rules for the Gastric Cancer study), there is no statistical significance in each stage between 2 groups. There is a possibility of exposure to cancer cells as a result of additional resectin, but the prognosis of exposed patients was almost the same as those without exposure. We concluded that intraoperarive additional resection was avairable technique in terms of curability.

Key words
gastric cancer, intraoperative additional resection for positive tumor invasion at the surgical margin, prognosis and recurrence of gastric cancer with additional resection,, en bloc resection of gastric cancer

Reprint requests
Yoshihiro Moriwaki Department of Surgery, Yokohama Red Cross Hospital
2-85 Negishi-cho, Naka-ku, Yokohama, 231 JAPAN

Accepted
May 11, 1994

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