Letters To The Editor
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World J Gastroenterol. Nov 28, 2014; 20(44): 16793-16794
Published online Nov 28, 2014. doi: 10.3748/wjg.v20.i44.16793
Individualized proximal margin for early gastric cancer patients
Xin-Zu Chen, Wei-Han Zhang, Jian-Kun Hu
Xin-Zu Chen, Wei-Han Zhang, Jian-Kun Hu, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Chen XZ wrote the letter; Chen XZ and Zhang WH reviewed the literature; Hu JK proofread the letter.
Supported by Grants from National Natural Science Foundation of China, No. 81372344 and No. 81301866
Correspondence to: Jian-Kun Hu, MD, PhD, Professor, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. hujkwch@126.com
Telephone: +86-28-85422479 Fax: +86-28-85164035
Received: March 27, 2014
Revised: April 30, 2014
Accepted: July 24, 2014
Published online: November 28, 2014
Processing time: 250 Days and 2.9 Hours
Abstract

There is no robust evidence to define a safe proximal margin by distance for early gastric cancer (EGC). The discussion on resection margin should not only focus on the oncologic safety, but also the postgastrectomy quality of life. The distance 1-10 mm is only acceptable for those endoscopic treatment fit EGC patients. For endoscopic unfit EGC cases, if the borderline of tumor is able to be clearly determined intraoperatively, the distance 1-3 cm is recommended for proximal resection margin. If there is any uncertainty on the tumor borderline, the distance 3-5 cm should be considered for proximal margin.

Keywords: Early gastric cancer; Gastrectomy; Margin; Oncologic safety; Quality of life

Core tip: There is no robust evidence to define a safe proximal margin by distance for early gastric cancer (EGC). The distance 1-10 mm is only acceptable for those endoscopic treatment fit EGC patients. For endoscopic unfit EGC cases, if the borderline of tumor is able to be clearly determined intraoperatively, the distance 1-3 cm is recommended. If there is any uncertainty on the tumor borderline, the distance 3-5 cm should be considered.