Objective  To investigate the clinicopathological characteristics of patients with positive resection margin after radical surgery for gastric cancer and the impact of positive margin on prognosis.

  Methods  We retrospectively collected the clinicopathological data of gastric cancer patients with positive resection margins admitted to Fourth Hospital of Hebei Medical University for radical gastrectomy from January 2011 to January 2016. Patients with negative resection margins admitted at the same period were selected using the random number method (ratio, 2∶1), and the general clinicopathological characteristics and prognosis of patients with positive and negative margins were compared.

  Results  In total, 73 patients with positive resection margins and 146 with negative resection margins were included. Compared to patients with negative margins, those with positive margins had larger tumor sizes, greater number of tumors in the cardia or whole stomach, worse histological types, advanced tumor pTNM stages, and higher rates of vascular invasion and lymph node metastasis; their Lauren type tended to be diffuse, Borrmann type tended to be types Ⅲ–Ⅳ, and tumor invasion depth mostly T4a-4b. The difference in operative experience and surgical methods was also associated with positive margin (all P<0.05). A total of 205 patients were followed up completely. There were significant differences in 5-year overall survival (OS) and progression-free survival (PFS) between the two groups (23.19% vs. 58.82%, 15.94% vs. 47.06%, all P<0.001). Cox multivariate analysis showed that the resection margin status (P=0.012), tumor pTNM stage (P=0.023), and postoperative comprehensive treatment (chemotherapy/chemoradiotherapy, P<0.001) were independent factors for the prognosis of gastriccancer.

  Conclusions  The resection margin status after radical gastric cancer is related to various clinicopathological characteristics, and patients with positive margins have a poor prognosis.