ArticleAnnals of surgical oncology2022
Impact of Surgical Margins on Overall Survival after Gastrectomy for Gastric Cancer: A Validation of Japanese Gastric Cancer Association Guidelines on a Western Series.
Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 27 citations in OpenAlex.
- Impact of Indocyanine Green Fluorescence Imaging on Lymphadenectomy Quality During Laparoscopic Distal Gastrectomy for Gastric Cancer (Greeneye): An Adaptative, Phase 2, Clinical Trial.Annals of surgical oncology · 2023Trial
- π-shaped anastomosis saves time yet may skew margin sampling in high tumors.Updates in surgery · 2026Article
- Epidemiology of Gastric Cancer in Korea (1999-2022): Incidence, Survival, and 5-Year Conditional Relative Survival.Journal of gastric cancer · 2026Article
- Function-preserving surgery in gastric cancer: current evidence and implications for the West.World journal of surgical oncology · 2025Review
- Long-term survival of gastric cancer patients with positive intraoperative frozen section margins: a single-cohort analysis.Korean journal of clinical oncology · 2025Article
- Indocyanine green fluorescence imaging in gastric cancer: Clinical efficacy, technical innovations, and future perspectives.World journal of gastrointestinal surgery · 2025Review
- Review
- Application of Survival Quilts for prognosis prediction of gastrectomy patients based on the Surveillance, Epidemiology, and End Results database and China National Cancer Center Gastric Cancer database.Journal of the National Cancer Center · 2024Article
- Esophagojejunostomy using a circular stapler vs. a linear stapler for gastric cardia cancer patients: impact of upper margin length and tumor size on the survival rate.Frontiers in surgery · 2024Article
- A shorter distal resection margin is a surrogate marker of nodal metastasis and poor prognosis in distal gastrectomy for advanced gastric cancer.BMC cancer · 2023Article
- Current management of gastric adenocarcinoma: a narrative review.Journal of gastrointestinal oncology · 2023Review
- Surgery Matters: Progress in Surgical Management of Gastric Cancer.Current treatment options in oncology · 2023Review
- Changes in Oncological Surgical Principles Driven by Advances in Preoperative Treatments.Therapeutics and clinical risk management · 2023Article
- Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeNo consensus exists on the resection extent needed to ensure oncological safety in gastrectomy for gastric adenocarcinoma (GAC). This study aims to assess the impact of margin adequacy according to Japanese Gastric Cancer Association (JGCA) guidelines on overall survival (OS). PATIENTS AND
methodsPatients who underwent surgery for stage I-III GAC at our institution between 2010 and 2017 were included. Margin adequacy according to JGCA, National Comprehensive Cancer Network (NCCN), and European Society for Medical Oncology (ESMO) guidelines was assessed, and their predictive value on OS was evaluated with Harrell's C-index. Patients were analyzed according to their margins' adherence to JGCA guidelines, and a propensity score matching (PSM) was run. Indication to either total gastrectomy (TG) or distal gastrectomy (DG) according to each guideline was also assessed.
resultsA total of 279 patients were included, of whom 220 (79%) underwent DG. Adequate margins according to JGCA were obtained in 209 patients (75%). On multivariate analysis, JGCA margin adequacy was independently associated with OS, together with American Society of Anesthesiologist class, neoadjuvant chemotherapy, lymphadenectomy extent, R0 resection, and postoperative N stage. After PSM, patients with JGCA adequate margins showed better OS, recurrence-free survival (RFS), and local RFS than patients with JGCA inadequate margins. For 220 DG, JGCA guidelines would have recommended TG in 25 patients (11%), NCCN in 30 (14%), and ESMO in 90 (41%) (p < 0.001).
conclusionAdequacy of surgical resection margins to JGCA guidelines leads to improved survival outcomes and allows for a more organ-preserving approach than Western guidelines.
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