{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T22:30:57Z","timestamp":1765405857855,"version":"3.46.0"},"reference-count":19,"publisher":"BMJ","issue":"6445","license":[{"start":{"date-parts":[[1984,9,8]],"date-time":"1984-09-08T00:00:00Z","timestamp":463449600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1984,9,8]]},"abstract":"<jats:p>In a prospective multicentre study of gastric adenocarcinoma the problem of microscopic disease at the resection line was investigated. Of 390 patients with resected gastric cancer, 85 (22%) had disease of the resection margins--32 at the oesophagus, 20 at the gastric margin, 17 at the duodenum, and six at both margins (10 were unspecified). Some 105 resections were considered palliative and 285 curative; 39 and 46 respectively had resection line disease. When resection margin clearance had been achieved a significantly improved survival was found, both overall (p = 0.0001), in the curative group (p = 0.0009), and in those with serosal disease but no microscopic disease of the lymph nodes (p = 0.0109). When the resection margin was diseased the survival rate for TNM stage IIS fell to that of stage IVA; 16% of those having curative surgery had had inadequate resections. The results of this study show that microscopic disease at the resection line influences long term survival and that surgeons should ensure that resection lines are clear. It also shows that the classification of patients who have resection line disease should be downgraded to stage IVA in the TNM staging system and they should be considered to have had only a palliative resection.<\/jats:p>","DOI":"10.1136\/bmj.289.6445.601","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"601-603","source":"Crossref","is-referenced-by-count":28,"title":["Resection line disease in stomach cancer. British Stomach Cancer Group."],"prefix":"10.1136","volume":"289","member":"239","published-online":{"date-parts":[[1984,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1136\/bmj.282.6271.1223","article-title":"How far down the duodenum?","volume":"282","author":"Nicholls, J.C.; Smith, P.A.","year":"1981","unstructured":"Nicholls JC, Smith PA. How far down the duodenum? Br Med J 1981;282: 1223-4.","journal-title":"Br Med J"},{"key":"ref_2","article-title":"TNM Classification of malignant tumours","author":"against Cancer, U.I.C.C.-International Union","year":"1978","unstructured":"UICC-International Union against Cancer. TNM Classification of malignant tumours. 3rd ed. Geneva: UICC, 1978.","edition":"3rd ed"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1007\/BF01658089","article-title":"An interim report of a prospective randomised controlled study of adjuvant chemotherapy in operable gastric cancer","volume":"7","author":"Fielding, J.W.L.; Fagg, S.L.; Jones, B.G.","year":"1983","unstructured":"Fielding JWL, Fagg SL, Jones BG, et al. An interim report of a prospective randomised controlled study of adjuvant chemotherapy in operable gastric cancer. British Stomach Cancer Group. World J Surg 1983;7:390-9.","journal-title":"British Stomach Cancer Group. World J Surg"},{"key":"ref_4","article-title":"Clinicopathological staging of gastric cancer","author":"Fielding, J.W.L.; Roginski, C.; Ellis, D.","unstructured":"Fielding JWL, Roginski C, Ellis D, et al. Clinicopathological staging of gastric cancer. Br J Surg (in press).","journal-title":"Br J Surg"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/bjc.1977.1","article-title":"Design and analysis of randomised clinical trials requiring prolonged observation of each patient","volume":"35","author":"Peto, R.; Pike, M.C.; Armitage, P.","year":"1977","unstructured":"Peto R, Pike MC, Armitage P, et al. Design and analysis of randomised clinical trials requiring prolonged observation of each patient. II. Analysis and examples. Br J Cancer 1977;35:1-39.","journal-title":"II. Analysis and examples. Br J Cancer"},{"key":"ref_6","first-page":"77","article-title":"Cancer of the Stomach at Cancer Institute Hospital, Tokyo","volume":"22","author":"Kajitani, T.; Takagi, K.","year":"1979","unstructured":"Kajitani T, Takagi K. Cancer of the Stomach at Cancer Institute Hospital, Tokyo. Gann Monograph in Cancer Research 1979;22:77-87.","journal-title":"Gann Monograph in Cancer Research"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/BF01665086","article-title":"Results of Surgery for gastric cancer and effect of adjuvant mitomycin C in Cancer recurrence","volume":"1","author":"Imanaga, H.; Nakazoto, H.","year":"1977","unstructured":"Imanaga H, Nakazoto H. Results of Surgery for gastric cancer and effect of adjuvant mitomycin C in Cancer recurrence. WorldJa Surg 1977;1:213-27.","journal-title":"WorldJa Surg"},{"key":"ref_8","article-title":"Lehrbuch derpathologischen Anatomie","author":"Rokitansky, C.","unstructured":"Rokitansky C. Lehrbuch derpathologischen Anatomie. 3rd ed. Vienna: w Braumiller, 1861. (Cited by Nicholls.')","edition":"3rd ed"},{"issue":"103","key":"ref_9","first-page":"348","article-title":"Extension of gastric carcinoma into the duodenum","volume":"1936","author":"Castleman, B.","unstructured":"Castleman B. Extension of gastric carcinoma into the duodenum. Ann Surg 1936;103:348-52.","journal-title":"Ann Surg"},{"issue":"3","key":"ref_10","first-page":"557","article-title":"Extension of carcinoma of the stomach into the duodenum and oesophagus","volume":"130","author":"Zinninger, M.M.; Collins, W.T.","year":"1949","unstructured":"Zinninger MM, Collins WT. Extension of carcinoma of the stomach into the duodenum and oesophagus. Ann Surg 1949;130 (3):557-66."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1097\/00000658-198212001-00012","article-title":"Adequacy of margins of resection in gastrectomy for Cancer","volume":"196","author":"Bozzetti, F.; Benfanti, G.; Bufaund, R.","year":"1982","unstructured":"Bozzetti F, Benfanti G, Bufaund R, et al. Adequacy of margins of resection in gastrectomy for Cancer. Ann Surg 1982;196:685-90.","journal-title":"Ann Surg"},{"key":"ref_12","first-page":"416","article-title":"Carcinoma of oesophagus 1965: Evolution of treatment","volume":"1","author":"Groves, L.K.","year":"1965","unstructured":"Groves LK. Carcinoma of oesophagus 1965: Evolution of treatment. Ann Thorac Surg 1965;1:416-31."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1001\/archsurg.1941.01210170015002","article-title":"Regional lymphatic metastases of carcinoma of the stomach","volume":"43","author":"Coller, F.A.; McIntyre, R.S.","year":"1941","unstructured":"Coller FA, McIntyre RS. Regional lymphatic metastases of carcinoma of the stomach. Arch Surg 1941;43:748-61.","journal-title":"Arch Surg"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/0002-9610(80)90369-4","article-title":"Histologically positive esophageal margin in the surgical treatment of gastric cancer","volume":"139","author":"Papachristou, D.N.; Agnanti, N.; D'Agostino, H.; Fortner, J.G.","year":"1980","unstructured":"Papachristou DN, Agnanti N, D'Agostino H, Fortner JG. Histologically positive esophageal margin in the surgical treatment of gastric cancer. Am J7 Surg 1980;139:711-3.","journal-title":"Am J7 Surg"},{"key":"ref_15","first-page":"185","article-title":"The influence of stage, inadequate resection and surgical reconstruction on morbidity and mortality in gastric cancer","volume-title":"Congress on Diagnosis and Treatment of Upper GI Tumours. Mainz Sept 9-11 1980","author":"Fielding, J.W.L.; Ellis, D.J.; Jones, B.G.","year":"1981","unstructured":"Fielding JWL, Ellis DJ, Jones BG, et al. The influence of stage, inadequate resection and surgical reconstruction on morbidity and mortality in gastric cancer. In: Friedman M, Ogana M, Kisner D, eds. International Congress on Diagnosis and Treatment of Upper GI Tumours. Mainz Sept 9-11 1980. Amsterdam: Elsevier-North Holland, 1981:185-95."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1097\/00000658-197505000-00015","article-title":"An analysis of twenty years experience with operation for carcinoma of the stomach","volume":"181","author":"White, R.R.; Mackie, J.A.; Fitts, W.T.","year":"1975","unstructured":"White RR, Mackie JA, Fitts WT. An analysis of twenty years experience with operation for carcinoma of the stomach. Ann Surg 1975;181:611-5.","journal-title":"Ann Surg"},{"key":"ref_17","first-page":"101","article-title":"Further surgical management of gastric ulcer with unsuspected mailgnant change","volume":"57","author":"Desmond, A.; Nichols, J.; Brown, C.","year":"1975","unstructured":"Desmond A, Nichols J, Brown C. Further surgical management of gastric ulcer with unsuspected mailgnant change. Ann R Coll Surg Engl 1975;57:101.","journal-title":"Ann R Coll Surg Engl"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/bjs.1800680203","article-title":"Peroperative frozen section and cytology to assess proximal invasion in gastro-oesophageal carcinoma","volume":"68","author":"Keighley, M.R.B.; Moore, J.; Lee, JR","year":"1981","unstructured":"Keighley MRB, Moore J, Lee JR, et al. Peroperative frozen section and cytology to assess proximal invasion in gastro-oesophageal carcinoma. Br J Surg 1981; 68:73-4.","journal-title":"Br J Surg"},{"article-title":"Accepted","year":"1984","key":"ref_19","unstructured":"(Accepted 9 July 1984)"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.289.6445.601","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.289.6445.601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T22:26:52Z","timestamp":1765405612000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.289.6445.601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,9,8]]},"references-count":19,"journal-issue":{"issue":"6445","published-online":{"date-parts":[[1984,9,8]]},"published-print":{"date-parts":[[1984,9,8]]}},"alternative-id":["10.1136\/bmj.289.6445.601"],"URL":"https:\/\/doi.org\/10.1136\/bmj.289.6445.601","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"type":"print","value":"0007-1447"},{"type":"electronic","value":"1468-5833"}],"subject":[],"published":{"date-parts":[[1984,9,8]]}}}