Effect of residual marginal tumor cells on recurrence pattern and long-term prognosis of locally advanced gastric cancer
Objective To investigate the recurrence pattern and long-term prognosis of locally advanced gastric can-cer after adjuvant chemotherapy with residual marginal tumor cells(R1 resection).Method A total of 440 patients with locally advanced gastric cancer underwent D2 radical resection were collected.The clinical features,recurrence patterns and prognosis of R0 resection(414 cases)and R1 resection(26 cases)were compared.Result Before propensity match-ing,there were statistically significant differences in N stage and peritumor intravascular cancer embol between R0 resec-tion and R1 resection in patients with locally advanced gastric cancer(P<0.05).After propensity matching,there were no significant differences in various clinical features between R0 resection and R1 resection in patients with locally ad-vanced gastric cancer(P>0.05).There was no significant difference in recurrence pattern between R0 resection and R1 re-section in patients with locally advanced gastric cancer(P>0.05).Before propensity matching,there were statistically sig-nificant differences in overall survival and relapse-free survival between R0 resection and R1 resection in patients with lo-cally advanced gastric cancer(P<0.01).After propensity matching,there were no significant differences in overall surviv-al and relapse-free survival between R0 resection and R1 resection in patients with locally advanced gastric cancer(P>0.05).After propensity matching,there was no significant difference in the survival of R1 resection patients with locally advanced gastric cancer treated with different chemotherapy regimen(P>0.05).Conclusion R1 resection in patients with locally advanced gastric cancer is usually associated with later stage,worse biological behavior and prognosis.Post-operative adjuvant therapy for patients with R1 resection gastric cancer should be based on the principle that local therapy does not affect systemic drug therapy.
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