THE SIGNIFICANCE OF HISTOLOGICALLY INFILTRATED RESECTION MARGIN AFTERESOPHAGECTOMY FOR ESOPHAGEAL CANCER

BACKGROUND: Microscopic tumor infiltration of the resection margin aft er esophageal resection is implicated to influence anastomotic leakage , tumor recurrence rates, and long-term survival. METHODS: Patients wi th tumor infiltration of resection margin (RM+) and those without (RM- ) were compared. RESULTS: Of 604 patients, 45 (7.5%) were RM+, Patient s in the RM+ group had more palliative resections, 76% versus 56%, P = 0.01, Anastomotic leakage rates were 2.2% (RM+) and 4.1% (RM-), P = 1 .0. Excluding hospital deaths, anastomotic recurrences developed in 10 .3% in the RM+ group and 4.9% in the RM- groups, P = 0.15. Although a positive margin did not increase anastomotic recurrence, a shorter res ection margin correlated with such recurrence. The mean (SEM) lengths of resection margins in surgical specimens were 2.7 cm (0.3) and 4.4 c m (0.1) for those with and without recurrence, P<0.001. Median surviva l time were 8.8 months (RM+) and 15 months (RM-), P = 0.007. CONCLUSIO NS: Histologic infiltration of resection margins did not influence lea kage rate. Anastomotic recurrence was related to the length of resecti on margin. (C) 1998 by Excerpta Medica, Inc.