The significance of histologically infiltrated resection margin after esophagectomy for esophageal cancer

Background: Microscopic tumor infiltration of the resection margin after esophageal resection is implicated to influence anastomotic leakage, tumor recurrence rates, and long-term survival. Methods: Patients with tumor infiltration of resection margin (RM+) and those without (RM−) were compared. Results: Of 604 patients, 45 (7.5%) were RM+. Patients in the RM+ group had more palliative resections, 76% versus 56%, P = 0.01. Anastomotic leakage rates were 2.2% (RM+) and 4.1% (RM−), P = 1.0. Excluding hospital deaths, anastomotic recurrences developed in 10.3% in the RM+ group and 4.9% in the RM− groups, P = 0.15. Although a positive margin did not increase anastomotic recurrence, a shorter resection margin correlated with such recurrence. The mean (SEM) lengths of resection margins in surgical specimens were 2.7 cm (0.3) and 4.4 cm (0.1) for those with and without recurrence, P<0.001. Median survival time were 8.8 months (RM+) and 15 months (RM−), P = 0.007. Conclusions: Histologic infiltration of resection margins did not influence leakage rate. Anastomotic recurrence was related to the length of resection margin