Length of negative resection margin does not affect local recurrence and survival in the patients with gastric cancer

AIM:To investigate the influence of the resection margin on local recurrence and survival in gastric cancer patients.METHODS:We reviewed the medical records of 1788patients who had undergone gastrectomy for gastric cancer at the Seoul National University Bundang Hospital,South Korea,between May 2003 and July 2009.The patients were divided into early and advanced gastric cancer groups.In each group,we analyzed the relationship between clinicopathologic factors and survival outcomes,and compared the hazard rates of event occurrence between patients with resection margins above and below the cut-off value,using a Cox proportional hazard model.RESULTS:The early and advanced gastric cancer groups included 1001 and 787 patients,respectively.The hazard rates of event occurrence did not significantly differ between the patients with resection margins above the cut-off value and those with resection margins below the cut-off value(P>0.05,in all comparisons).Based on the multivariable analyses,the proximal and distal resection margins were not significantly associated with survival outcomes and local recurrence(P>0.05,in all analyses).CONCLUSION:The proximal or distal resection margins did not affect the prognosis of patients with gastric cancer if the margins were pathologically negative.

Sex-based differences in histology,staging,and prognosis among 2983 gastric cancer surgery patients

BACKGROUND Few studies have been conducted on sex differences in the incidence, pathophysiology, and prognosis of gastric cancer(GC).AIM To analyze the differences in GC characteristics according to sex in patients who underwent surgical treatment for GC.METHODS A total of 2983 patients diagnosed with gastric adenocarcinoma who received surgical treatment at the Seoul National University Bundang Hospital between 2003 and 2017 were included.Baseline clinicopathological characteristics, histologic type of GC, overall and GC-specific survival rates, and associated risk factors were analyzed.RESULTS Among the 2983 patients, 2005(67.2%) and 978(32.8%) were males and females, respectively.The average age of the female group(59.36 years) was significantly younger than that of the male group(61.66 years;P < 0.001).Cancer of the gastric body(P < 0.001) and diffuse-type histology(P < 0.001) were more common in females than in males.This trend was more prominent in females younger than 60 years of age, with a significantly higher proportion of diffuse-type cancer than in the male group.Regardless of sex, diffuse-type GC was more common in younger patients, and the proportion of intestinal-type GC increased with age.The overall survival rate was significantly higher in females(P < 0.001).However, this difference disappeared for GC-specific survival(P = 0.168), except for the poor GC-specific survival rate in advanced-stage cancer(stage Ⅲ or above) in females(P = 0.045).The risk factors for GC-related mortality were older age, upper location of GC, and diffuse-or mixed-type histology.In terms of comorbidities, more males died from diseases other than GC, including other malignancies such as lung cancer, hepatocellular carcinoma, and pancreatic cancer, and respiratory diseases such as interstitial lung disease and chronic obstructive pulmonary disease, while there were relatively more cardiovascular or cerebrovascular deaths in females.CONCLUSION Sex-based differences in GC were observed in clinicopathological features, including age at diagnosis, tumor location, histologic type, survival rate, and comorbidities.