Predictors And Precautionary Approaches Of Positive Margins After Gastrectomy In Gastric Cancer

Objective：To discuss the predictors and precautionary approaches of positivemargins after potentially radical gastrectomy in gastric cancer.Methods: Clinicopathologic features of1280gastric cancer patients who underwentpotentially radical gastrectomy in the First Affiliated Hospital of Fujian MedicalUniversity from January2010to April2013were retrospectively collected. Thepatients were grouped into two according to the margin status: Group1(62patients),positive margin; Group2(1218patients), negative margin. The relationships betweenthe margin status and other clinicopathologic factors were examined by Chi-squaretest, T test and Logistic regression model.Result:According to Chi-square test and T test, there were significant differences inlarger tumor (≥5cm), cancer infiltrated gastric cardia or total stomach, totalgastrectomy, advanced cancer, Bauman type Ⅲ and Ⅳ, lymphatic vessel invasion,poor differentiation, signet ring cell carcinoma, advanced pT stage (serosal invasion),advanced pN stage (pN2-3) and advanced pTNM stage (Ⅲ) between patients withnegative and positive margins（P<0.05）. Multivariate logistic regression analysisidentified pN stage (P=0.001) and tumor size (P=0.015) as independentlycorrelated with a positive margins.Conclusion: To examine clinicopathologic features through preoperative andintraoperative evaluation, and take appropriate surgery or expand the resection extentto the patients who have predictors of positive margins is an important way to preventa positive margin.