Influence of a microscopic positive proximal margin in the treatment of gastric adenocarcinoma of the cardia

325 589

Cited 34 times in

Authors: Jian-Guo Shen ; Jae-Ho Cheong ; Woo-Jin Hyung ; Junuk Kim ; Seung-Ho Choi and Sung-Hoon Noh

MeSH: Adenocarcinoma/pathology* ; Adenocarcinoma/surgery* ; Adult ; Aged ; Aged, 80 and over ; Cardia/pathology* ; Cardia/surgery ; Disease-Free Survival ; Female ; Gastrectomy/methods* ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness/pathology ; Neoplasm Recurrence, Local/prevention & control ; Neoplasm, Residual ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery* ; Survival Analysis

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.