Adenocarcinoma of the stomach can be treated surgically under certain conditions by means of distal gastric resection. One factor for this is a necessary proximal safety distance to the tumor of either 5 cm or 8 cm, depending on the tumor histology. However, there has been a lack of data to date for more precise determinations and effects on survival.
A team from the Department of General, Visceral and Transplant Surgery at Heidelberg University Hospital (Germany) has now investigated the influence of the proximal safety margin of the different histological types of gastric carcinoma on survival and the recurrence-free interval after distal gastrectomy [1]. The scientists included patients with adenocarcinoma of the stomach in their study who underwent curative resection by distal gastric resection at Heidelberg University Hospital between October 2001 and March 2022. The retrospective evaluation was based on a prospectively managed database.
A total of 176 patients were identified and divided into two groups (safety margin <5 cm bzw.>5 cm) and according to tumor histology. The influence on survival and the recurrence-free interval was analyzed using Kaplan-Meier analysis and Cox regression. As a result, there was no significant difference in the safety margin between the different tumor histologies (intestinal: 4.9 +/- 2.8; mixed: 5.1 +/- 2.9; diffuse: 5.7 +/- 3.0). There was also no difference in terms of overall survival (p=0.261) or the recurrence-free interval (p=0.947). The evaluation within the individual groups and also between the groups with differentiation of the safety distance <5 cm und>5 cm showed no influence on overall survival or the recurrence-free interval.
The definition of a safety distance of 5 cm or 8 cm shows no relevant influence on overall survival, the group concluded from the data. Future studies are needed to define the extent of resection of the distal gastrectomy.
Congress: Viszeralmedizin 2023
Source:
- Schütte I: Vortrag «Notwendigkeit eines proximalen Sicherheitsabstandes von mehr als 5cm bei distaler Gastrektomie?»; Sitzung «CAOGI/ACO: Anastomosentechniken an Ösophagus und Magen – Technik und Komplikationsmanagement»; Viszeralmedizin 2023, Hamburg, 14.09.2023; Z Gastroenterol 2023; doi: 10.1055/s-0043-1771685.
GASTROENTEROLOGIE PRAXIS 2023: 1(2): 34
