For the majority of GI cancers surgical resection is the mainstay of treatment.
Malignancies involving stomach, pancreas, bile ducts and esophagus that leave residual tumor (R2 resection) at the time of surgery yield no survival advantage when compared to patients not undergoing resection at all.
Following complete resection and removal of all gross malignant disease a significant survival difference between negative and positive microscopic margins exist.
The presence of positive resection margins for pancreatic, rectal, gastric, esophageal, and hepatectomy for colorectal cancer have negative effect on survival.
In patients undergoing curative resections for pancreas, esophageal, gastric and colorectal cancers the presence of an anastomotic leak, postoperative weight loss, and delayed recovery are significant factors in the development of recurrent disease (Attili VSS).
Morbidity associated with gastrointestinal surgical resections can cause a delay or even the inability to deliver appropriate adjuvant therapy resulting in a higher recurrence rate.