Positive proximal resection margins after resection for carcinoma of the oesophagus and stomach: effect on survival and symptom recurrence

Aust N Z J Surg. 1996 Nov;66(11):734-7. doi: 10.1111/j.1445-2197.1996.tb00732.x.


Background: Our aim was to determine the frequency, survival and symptomatic local recurrence rate of patients with a positive proximal resection margin in a series of patients having a resection for carcinoma of the oesophagus or stomach.

Methods: A retrospective study of pathology reports and case notes. Survival and data on local recurrence were obtained from the patient or general practitioner.

Results: Ten (11.5%) of 87 patients having a gastric or oesophageal resection for carcinoma had a positive proximal resection margin. All 10 patients underwent a palliative resection for late-stage disease. Nine were dead at an average 8.3 months (range 2-20 months) post-resection and one patient remains alive at 9 months. Only one of these 10 patients had evidence of a local recurrence with recurrent dysphagia prior to death at 11 months.

Conclusion: A high incidence of a positive proximal resection margin was found. This occurred in patients who underwent a palliative resection for late-stage disease, most of whom died before local recurrence became a problem. For patients recognized as having late-stage disease, surgery for symptom palliation need not be aggressive (such as to include a thoracotomy) because achieving microscopic clearance is unlikely to affect the long-term outcome.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Roux-en-Y
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Female
  • Gastrectomy / methods*
  • Gastroenterostomy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Palliative Care
  • Retrospective Studies
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / surgery*
  • Survival Rate
  • Treatment Outcome