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

AIM： To investigate the influence of a positive proximal margin in total gastrectorny patients with gastric adenocarcinorna of the cardia. METHODS： Medical records of 191 patients with total gastrectornies for adenocarcinorna 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.