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World J Gastroenterol. Jun 28, 2006; 12(24): 3883-3886
Published online Jun 28, 2006. doi: 10.3748/wjg.v12.i24.3883
Influence of a microscopic positive proximal margin in the treatment of gastric adenocarcinoma of the cardia
Jian-Guo Shen, Jae-Ho Cheong, Woo-Jin Hyung, Junuk Kim, Seung-Ho Choi, Sung-Hoon Noh
Jian-Guo Shen, Jae-Ho Cheong, Woo-Jin Hyung, Junuk Kim, Seung-Ho Choi, Sung-Hoon Noh, Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, Korea
Jian-Guo Shen, Department of Surgical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China
Author contributions: All authors contributed equally to the work.
Supported by the Korean Science and Engineering Fund through the Cancer Metastasis Research Center at Yonsei University
Correspondence to: Dr. Sung Hoon Noh, Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, Korea. sunghoonn@yumc.yonsei.ac.kr
Telephone: +82-2-2228114 Fax: +82-2-3138289
Received: September 28, 2005
Revised: October 15, 2005
Accepted: October 26, 2005
Published online: June 28, 2006
Abstract

AIM: To investigate the influence of a positive proximal margin in total gastrectomy patients with gastric adenocarcinoma of the cardia.

METHODS: Medical records of 191 patients with total gastrectomies for adenocarcinoma of the cardia between 1995 and 2000 were reviewed. The clinicopathologic features associated with a positive margin were determined, and the predictors for survival were analyzed.

RESULTS: The incidence of positive proximal margin was 8.4% (16/191). The positive margins were associated with advanced diseases. The tumor size and the depth of tumor invasion were independent risk factors for a positive margin. The mean survival in the positive margin group was 33.9 mo as compared with 62.4 mo in the negative group (P < 0.001). However, the difference in survival lost significance in subgroup analysis according to stage. Multivariate analysis identified that a positive margin was not an independent prognostic factor for survival.

CONCLUSION: A positive margin is more of an indication of advanced disease in patients with gastric adenocarcinoma of the cardia rather than an independent prognostic factor for survival.

Keywords: Resection margin, Gastric cancer, Total gastrectomy, Outcome