Appropriate gastrectomy resection margins for early gastric carcinoma

In Korea and Japan, early gastric cancer (EGC) accounts for >50% of all gastric cancers. Here, we propose recommendations for the optimal distance from the tumor to the resection margins when evaluating EGC.

There are very few guidelines regarding the distance from the EGC tumor to the resection margins.

We evaluated 2,081 patients who underwent gastrectomy for EGC between January 1989 and May 2000. We subdivided tumors according to the distance from the proximal margin: ≤ 1, >1, ≤ 10, >10, ≤ 30, or >30 mm.

Three of five patients demonstrating distances ≤ 1 mm between the tumor and gross proximal margin were microscopically positive. No patients with gross proximal margins >1, ≤ 10, >10, or ≤ 30 mm were microscopically positive. There were no statistical differences in rates of microscopically positive margin, reresection, or reoperation between groups (P > 0.05). In addition, there were statistical differences in terms of tumor recurrence and disease-related death between groups (P > 0.05).

When the resection margins are clear, we propose that margins >1 mm are adequate for EGC gastrectomy.