Relevant risk factors of positive lateral margin after en bloc endoscopic submucosal dissection for early gastric adenocarcinoma

Abstract

Background

Endoscopic submucosal dissection is a standard treatment for early gastric cancer at present, while it has a risk of resection margin residual due to the minimal resection. Therefore, it's indispensable to have an accurate diagnosis of cancer borders for reaching a complete resection.

Aims

This study was to systematically assess the relevant risk factors of positive lateral margin after en bloc resection of early gastric cancer.

Methods

We retrospectively studied 355 Endoscopic submucosal dissection procedures for gastric epithelial neoplasm from 2009 to 2015. A total of 242 lesions were extracted and all were grouped by lateral margin status. Clinicopathological features and risk factors of positive lateral margin were analysed.

Results

The curative rate was 82.2% and the incidence of positive lateral margin was 12.4%. By univariate analysis, positive lateral margin was significantly associated with the tumor location, size, histological findings, lymphovascular invasion and invasion depth. Besides, positive lateral margin has a higher incidence of recurrence/residual tumors. Multivariate analysis showed that the location, diameter and histological classification of tumors were independent risk factors of positive resection margins.

Conclusion

The positive lateral margin is closely related to the upper third of stomach, tumor larger than 3 cm and the mixed-type carcinoma. Additionally, positive lateral margin has an inclination for recurrence/residual tumors.

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