Cargando…
Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer: A Retrospective Study
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 possibil...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health, Inc.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10431292/ https://www.ncbi.nlm.nih.gov/pubmed/37600106 http://dx.doi.org/10.1097/AS9.0000000000000127 |
_version_ | 1785091166238146560 |
---|---|
author | Koterazawa, Yasufumi Ohashi, Manabu Hayami, Satoshi Kumagai, Koshi Sano, Takeshi Nunobe, Souya |
author_facet | Koterazawa, Yasufumi Ohashi, Manabu Hayami, Satoshi Kumagai, Koshi Sano, Takeshi Nunobe, Souya |
author_sort | Koterazawa, Yasufumi |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-10431292 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer Health, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104312922023-08-18 Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer: A Retrospective Study Koterazawa, Yasufumi Ohashi, Manabu Hayami, Satoshi Kumagai, Koshi Sano, Takeshi Nunobe, Souya Ann Surg Open Original Study 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. Wolters Kluwer Health, Inc. 2022-01-13 /pmc/articles/PMC10431292/ /pubmed/37600106 http://dx.doi.org/10.1097/AS9.0000000000000127 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Study Koterazawa, Yasufumi Ohashi, Manabu Hayami, Satoshi Kumagai, Koshi Sano, Takeshi Nunobe, Souya Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer: A Retrospective Study |
title | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer: A Retrospective Study |
title_full | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer: A Retrospective Study |
title_fullStr | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer: A Retrospective Study |
title_full_unstemmed | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer: A Retrospective Study |
title_short | Minimum Esophageal Resection Length to Ensure Negative Proximal Margin in Total Gastrectomy for Gastric Cancer: A Retrospective Study |
title_sort | minimum esophageal resection length to ensure negative proximal margin in total gastrectomy for gastric cancer: a retrospective study |
topic | Original Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10431292/ https://www.ncbi.nlm.nih.gov/pubmed/37600106 http://dx.doi.org/10.1097/AS9.0000000000000127 |
work_keys_str_mv | AT koterazawayasufumi minimumesophagealresectionlengthtoensurenegativeproximalmarginintotalgastrectomyforgastriccanceraretrospectivestudy AT ohashimanabu minimumesophagealresectionlengthtoensurenegativeproximalmarginintotalgastrectomyforgastriccanceraretrospectivestudy AT hayamisatoshi minimumesophagealresectionlengthtoensurenegativeproximalmarginintotalgastrectomyforgastriccanceraretrospectivestudy AT kumagaikoshi minimumesophagealresectionlengthtoensurenegativeproximalmarginintotalgastrectomyforgastriccanceraretrospectivestudy AT sanotakeshi minimumesophagealresectionlengthtoensurenegativeproximalmarginintotalgastrectomyforgastriccanceraretrospectivestudy AT nunobesouya minimumesophagealresectionlengthtoensurenegativeproximalmarginintotalgastrectomyforgastriccanceraretrospectivestudy |