Schwartz's Principles of Surgery ABSITE and Board Review, Ninth Edition by F. Brunicardi & Mary Brandt & Dana Andersen & Timothy Billiar & David Dunn & John Hunter & Jeffrey Matthews & Raphael E. Pollock

Author:F. Brunicardi & Mary Brandt & Dana Andersen & Timothy Billiar & David Dunn & John Hunter & Jeffrey Matthews & Raphael E. Pollock [Brunicardi, F.]
Language: eng
Format: epub
Publisher: McGraw-Hill Education
Published: 2010-10-15T06:00:00+00:00

B. 3 cm

C. 4 cm

D. 5 cm

Answer: D

The goal of curative surgical treatment is resection of all tumor (i.e., R0 resection). Thus, all margins (proximal, distal, and radial) should be negative and an adequate lymphadenectomy performed. Generally, the surgeon strives for a grossly negative margin of at least 5 cm. Some gastric tumors, particularly the diffuse variety, are quite infiltrative and tumor cells can extend well beyond the tumor mass; thus, gross margins beyond 5 cm may be desirable. Frozen section confirmation of negative margins is important when performing operation for cure, but it is less important in patients with nodal metastases beyond the N1 nodal basin. (See Schwartz 9th ed., p 933.)

12. What is the minimal number of lymph nodes considered to be adequate for staging when resecting an adenocarcinoma of the stomach?

A. 10