Mide karsinomalı hastalarda mikroskopik rezeksiyon sınırı tutulumunun prognostik önemi

Amaç:Gastrektomi sonrasında mikroskopik sınır tutulumu saptanan mide karsinomalı hastalarda rerezeksiyonun yararlı olup olmadığı tartısmalıdır.Bu çalışmada mide karsinomalı hastaların değişik altgruplarında, rezeksiyon sınırında mikroskopik tümör tutulumunun prognostik önemi incelendi. Yöntem:Potansiyel olarak küratif rezeksiyon yapıldığı düşünülen mide karsinomalı 331 hasta çalışmaya alındı: veriler prospektif olarak toplandı. Ameliyat sonrası yapılan histopalolojik incelemede rezeksivon sınırlarında tümör görüldüğünde sınır pozitif olarak adlandırıldı. Sınır pozitif ve negatif hastalar klinikopatolojik özellikler, morlalite ve genel sağkalını açısından karşılaştırıldı. Komplikasyonlar nedeniyle ölen 30 hasta sağkalım analizine alınmadı. Bulgular:47(%14.2) hastada rezeksiyon sınırında tümör tutulumu vardı.6 cm'den büyük, andiferansiye, vasküler ve perinöral invazvonu olan tümörlerde sınır pozitifligi anlamlı olarak daha yüksek oranda idi. Sınır tutulumu olan ve olmayan hastaların erken mortalite oranları (Sırasıyla 5/47,%10.6 ve 25/284,%8.8)arasında anlamlı fark yoktu.Tüm seri için, 5-yıllık genel sağkalım sınır tutulumu olan hastalarda %2.4, olmayanlarda %32.8 idi (p

Prognostic significance of microscopic resection margin involvement in patients with gastric carcinoma

Objectives:It is controversial whether reresection subsequent to gastrectomy is beneficial in gastric carcinoma patients with confirmed microscopic resection margin involvement. In this study, the prognostic significance of microscopic tumor involvement in resection margin in various subgroups of patients with gastric carcinoma was investigated. Methods: Three hundred and thirty-one gastric carcinoma patients who were supposed to be resected curatively were included in the study; data was collected prospectively. When postoperative histologic examination revealed tumor in the resection margins, it was termed as margin positive. Margin positive and negative patient were compared with regard to histopathologic features, mortality and overall survival. Thirty patients who died ofcomplications were not included in survival analysis. Results:Tumor involvement in the resection margin was found in 47 (14.2%) patients. Margin positivity rales were; significantly higher in tumors over6 cm in size, in undifferentiated tumors, in tumors with vascular and perineural invasion.Early mortality rates did not diller significantly between patients with positive margin and with negative margin(5/47, 10.6% and.25/284, 8.8%, respectively).Considering the whole series, overall 5-year survival was 2.4% in patients with margin involvement and 32.8% in patients without margin involvement (p

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