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What is the optimal distal resection margin for esophageal carcinoma?
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Casson, Alan G, Darnton, S.Jane, Subramanian, Sujata and Hiller, Louise (2002) What is the optimal distal resection margin for esophageal carcinoma? In: Thirty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, 25-27 Jan 1999. Published in: The Annals of Thoracic Surgery, 69 (1). pp. 205-209. doi:10.1016/S0003-4975(99)01262-X ISSN 00034975.
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Official URL: http://dx.doi.org/10.1016/S0003-4975(99)01262-X
Abstract
Background. Whereas a proximal resection margin of 12 cm is recommended for complete resection of esophageal cancer, the extent of distal resection is unclear. Methods. We examined distal resection margins in a consecutive series of patients who underwent esophagectomy for squamous cell carcinomas (n = 50), primary esophageal adenocarcinomas (n = 100), and adenocarcinomas of the cardia (n = 39), in whom all macroscopic tumor was judged to be completely resected. Results. Microscopic tumor was found at a 3-cm distal resection margin for one multifocal squamous cell carcinoma. Positive distal resection margins were seen in 12% (12 of 100 patients) of primary esophageal adenocarcinomas (median, 2 cm versus 4 cm if negative; p = 0.002, Wilcoxon) and 28% (11 of 39 patients) of cardia adenocarcinomas (median, 1 cm versus 3 cm if negative; p = 0.02, Wilcoxon). Although pathologic stage was shown to be the only significant predictor of overall survival (Hazard ratio [HR] 1.8; 95% confidence interval 1.2 to 2.6; p = 0.007), there was a trend toward reduced postoperative survival for patients with histologically positive distal resection margins, in particular for patients with cardia adenocarcinomas (median, 15.4 months versus 5.7 months if negative; p = 0.0001). Conclusions. To achieve consistently negative distal resection margins, we recommend resection of at least 5 cm of macroscopically normal foregut below the distal margin of the primary tumor. © 2000 by The Society of Thoracic Surgeons.
| Item Type: | Conference Item (Poster) | ||||||
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| Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) R Medicine > RD Surgery |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | The Annals of Thoracic Surgery | ||||||
| ISSN: | 00034975 | ||||||
| Official Date: | 2002 | ||||||
| Dates: |
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| Volume: | 69 | ||||||
| Number: | 1 | ||||||
| Page Range: | pp. 205-209 | ||||||
| DOI: | 10.1016/S0003-4975(99)01262-X | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| Conference Paper Type: | Poster | ||||||
| Title of Event: | Thirty-fifth Annual Meeting of The Society of Thoracic Surgeons | ||||||
| Type of Event: | Conference | ||||||
| Location of Event: | San Antonio, TX | ||||||
| Date(s) of Event: | 25-27 Jan 1999 |
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