Akademik Veri Yönetim Sistemi
16th International Gastric Cancer Congress, Amsterdam, Hollanda, 7 - 10 Mayıs 2025, ss.1, (Tam Metin Bildiri)
Introduction
Gastric adenocarcinoma is the fourth most common cancer and is
responsible for 10% of cancer-related deaths worldwide. A
proximal margin of at least 3–4 cm is recommended in guidelines.
Methodology
Patients who underwent transabdominal total gastrectomy and D2
dissection due to proximal gastric adenocarcinoma, in the Upper
GI surgery unit of the General Surgery Department of Dokuz Eylul
University, between 2006 and 2024 were included in the study.
Patients with palliative resection, incomplete follow-up data, and
patients with less than 6 months follow-up period were excluded.
Two groups were formed according to neoadjuvant chemotherapy
status.
Group 1: Neoadjuvant chemotherapy negative
Group 2: Neoadjuvant chemotherapy positive
Demographic data, T stage, N stage, distance of the tumor to the
proximal resection margin and survival time were evaluated with
Student T-test and ChiSquare test. To evaluate the effect of tumor
proximity to the resection margin on survival, separate
evaluations were made for distances of 3mm, 10mm, 15mm,
20mm, 25mm and 30mm.To investigate the effect of neoadjuvant
chemotherapy on safe surgical margin distance, we examined
associations of surgical margin distance and survival times for two
groups with Kaplan Meier test.All statistical analysis was
performed with IBM SPSS Statistics Version 29.0.0.0.(241)
program.
Results
156 patients were included in the study. Group1 (Neoadjuvant
chemotherapy negative) included 97, Group2 (Neoadjuvant
chemotherapy positive) included 59 patients. There was no
statistically significant difference between the groups in terms of
age, gender, number of removed lymph nodes, T stage and N
stage.
Results for mean age was 65.05(±13.10) and 61.61(±10.62)
p=0.075; gender(male/female): 50(51.5%) / 47(48.5%) and
39(66.1%) / 20(33.9%) p=0.075; number of removed lymph
nodes: 31.8(±13.79) and 33.95(±13.61) p=0.34; T stage: (≤ T2 /
>T2): 22(22.7%) / 75(77.3%) and 9(15.3%) / 50 (84.7%) p=0.26;
N stage (≤N1 / >N1): 52(53.6%) / 45(46.4%) and 40(67.8%) /
19(32.2%) p=0.081 respectively for Group 1 and Group 2.
Mean follow-up time was 56.84 months. To evaluate the effect of
tumor proximity to the resection margin on survival, separate
evaluations were made for distances of 3 mm, 10 mm, 15 mm, 20
mm, 25 mm and 30 mm.
We found that survival decreased for Group 1 when the Surgical
margin distance was no more than 30 mm.
However, it was not concluded that tumor proximity to the surgical
margin negatively affected survival for Group 2.
Conclusion
For patients who will have difficulty achieving a proximal
surgical resection margin greater than 30mm especially
endoscopic procedures, neoadjuvant chemotherapy may
prevent a potential survival disadvantage.