The incidence and mortality of gastric cancer have been decreasing in western countries, but gastric cancer is the most common malignant neoplasm among Koreans. In Japan, there have been many important reports analysing dta based on the "General
Rules
for Gastric Cancer Study" of the Japances Research Society for Gastric Cancer since 1962, but a unified assessment system has been just recently established in Korea. The aims of this study were to evaluate appropriate resection margin, to
identify
characteristic of microscopically large cancers, and to analyze clinicopathologic data from mapping of gastric cancer.
For 5 years from January 1987 to December 1991, curative resection has been performed in 440 patients with gastric cancer at the Department of Surgery, National Medical center, and data were available from 372 patients. Resected stomachs were
examined
macroscopically by pathologist and cut into strips(5×30mm) for microscopic examination. The size and the shape of the lesion, the shape of the ulcer and the ulcer margin, the Borrmann type, the histologic type, the depth of invasion, the lymph
node
metastasis, the presence of associated pathology, and the stage were described and analysed for size discrepancy.
The average size of the lesions was 71.7×54.6mm macroscopically and 72.5×55.9mm microscopically, and there was no significant difference. There was significant discrepancy between gross and mapping size of the lesion in stage IV, N2, poorly
differentiated or signet-ring cell type, T4 invasion, Borrmann type IV, elliptically shaped lesion, with ovoid or geographically shaped ulcer, and with nodular ulcer margin. Our conclusions are that the proximal resection margin of 5cm is
acceptable and
the frozen section of the resection margin should be confirmed. Also we suspected that the gross features and the size discrepancy may have a relationship, but, this requires more investigation.
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