Annals of Surgical Oncology

, Volume 21, Issue 4, pp 1107–1114 | Cite as

The Prognostic Significance of an R1 Resection in Gastric Cancer Patients Treated with Adjuvant Chemoradiotherapy

  • Jurriën Stiekema
  • Anouk K. Trip
  • Edwin P. M. Jansen
  • Henk Boot
  • Annemieke Cats
  • Olga Balague Ponz
  • Marcel Verheij
  • Johanna W. van SandickEmail author
Gastrointestinal Oncology



A microscopically irradical (R1) resection is a well-known adverse prognostic factor after gastric cancer surgery. However, the prognostic significance of an R1 resection in gastric cancer patients who are treated with chemoradiotherapy (CRT) after the operation has been poorly studied. Therefore, the aim of this study was to evaluate the effect of an R1 resection on (recurrence-free) survival in gastric cancer patients who were treated with CRT after surgery.


Gastric cancer patients who had undergone a resection with curative intent followed by adjuvant CRT at our institute between 2001 and 2011 were included. CRT consisted of radiotherapy (45 Gy/25 fractions) combined with concurrent capecitabine (with or without cisplatin) or 5-fluorouracil/leucovorin.


A consecutive series of 110 patients was studied, including 80 (73 %) patients who had undergone an R0 resection and 30 (27 %) patients with an R1 resection. Pathologic T-classification (p = 0.26), N-classification (p = 0.77), and histologic subtype according to Laurén (p = 0.071) were not significantly different between these groups. Three-year recurrence-free survival (45 vs. 35 %, p = 0.34) and overall survival (47 vs. 48 %, p = 0.58) did not significantly differ between patients who had undergone an R0 or R1 resection. In a multivariate analysis, pathologic T-classification and N-classification were independent prognostic factors for survival.


A R1 resection was not an adverse prognostic factor in gastric cancer patients who had undergone CRT after the operation.


Gastric Cancer Overall Survival Gastric Cancer Patient Locoregional Recurrence Gastric Cancer Treatment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank Michael Hauptmann as the statistician who assisted with the statistical analyses.


Stichting Cornelis Vrolijk Development Fund.


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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Jurriën Stiekema
    • 1
  • Anouk K. Trip
    • 2
  • Edwin P. M. Jansen
    • 2
  • Henk Boot
    • 3
  • Annemieke Cats
    • 3
  • Olga Balague Ponz
    • 4
  • Marcel Verheij
    • 2
  • Johanna W. van Sandick
    • 1
    Email author
  1. 1.Department of SurgeryThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  2. 2.Department of Radiation OncologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  3. 3.Department of Gastroenterology and HepatologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  4. 4.Department of PathologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands

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