Evaluation of surgical margins of laparoscopic gastric cancer surgery: Single-center results

INTRODUCTION: Surgical margin positivity incidence is reported between 5 snd 20% in gastric cancer surgery. Although some studies showed that presence of positive surgical margins affects overall survival negatively, others reported no effect. The aim of this study is to investigate the relationship between surgical margin and the survival of patients who underwent laparoscopic gastrectomy in our clinic.
METHODS: Between 2015 and 2022 years, patients who underwent laparoscopic gastrectomy because of gastric cancer were included in this study. Surgical resection margin (diameter) width, microscopic evaluation of the surgical margin, pathological tumor stage, resected lymph nodes numbers and involvement, and overall survival were analyzed.
RESULTS: After patients with benign disorders and inadequate lymph nodes resection were excluded from the study, 136 patients were included the study. Median surgical margin length width? was 2.3 (0.1–10) cm, and 13 (9.6%) patients had positive surgical margin after pathological evaluation. Median survival was 51.00±18.56 months in patients with positive surgical margins and 46.00±2.99 months in patients with negative surgical margins (p=0.977). The 1, 3, and 5-year survival rates of patients with negative versus positive surgical margins (78.9% vs. 69.2%, p=0.426), (46.3% vs. 46.2%, p=0.990), and (17.1% vs. 30.8%, p=0.225), respectively. Surgical margin was positive in 3 (7.7%) patients with proximal tumors, and in 10 (10.3%) patients with distal located tumors.
DISCUSSION AND CONCLUSION: While most studies emphasized surgical margin positivity in proximal tumors, the rate of distal surgical margin positivity was found to be higher in this study. In conclusion, no correlation was found be-tween surgical margin positivity and overall survival.