The Influence of Proximal Resection Margin in Adenocarcinoma of the Gastroesophageal Junction on survival

Purpose: To determine the length of proximal resection margin for patients with adenocarcinoma of the gastroesophageal junction(GEJ).Materials and Methods: We reviewed retrospectively the medical records of the 289 patients who underwent surgery for adenocarcinoma of GEJ in our institution between Janury 2001 and December 2003.Result: The 289 patients who underwent surgery for adenocarcinoma of GEJ were divided on T stage, below T1 group(T1,n=66) and above T2 group(T2-4, n=223).We studied the influence of proximal resection margin in adenocarcinoma of the GEJ on survival.In T1(n=66) group, univariate analysis revealed no influence of proximal resection margin in adenocarcinoma of GEJ on survival.In T2-4(n=223) group, univariate analysis revealed influence of proximal resection margin on survival ; 0.5cm, 2.0cm, 3.0cm, 3.5cm, 4.0cm.Multivariate analysis show that only influence of proximal resection margin on survival; 0.5cm (p=0.009,HR:2.232, 95% CI:1.218-4.091)Conclusion: We should be undergoing surgery for T2-4 gastric adenocarcinoma of GEJ with safely proximal resection margin; >0.5cm for survival improvement.