Evidence map›Paper›PMID 41538115›Full record

ArticleAnnals of surgical oncology2026

Appropriate Proximal Resection Margin Distance for Esophagogastric Junction Adenocarcinoma.

Yuki Shin, Manabu Yamamoto, Mitsuhiko Ota, Tetsuro Kawazoe, Yoko Zaitsu, Kensuke Kudo, Ryota Nakanishi, Tomonori Nakanoko, Koji Ando, Yuichiro Nakashima and 5 more

Abstract read
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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Yuki ShinDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. y.shin.2719@gmail.com.
Manabu YamamotoDepartment of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Mitsuhiko OtaDepartment of Gastroenterological Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Tetsuro KawazoeDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Yoko ZaitsuDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Kensuke KudoDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Ryota NakanishiDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Tomonori NakanokoDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Koji AndoDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Yuichiro NakashimaDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Eiji OkiDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Yasue KimuraDepartment of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Kenichi TaguchiDepartment of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Masaru MoritaDepartment of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Tomoharu YoshizumiDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe purpose of this study was to clarify the appropriate proximal resection margin distance for esophagogastric junction (EGJ) adenocarcinoma and evaluate the impact on long-term outcomes. Proximal resection margin and lymph node dissection are critical factors in EGJ adenocarcinoma surgery. However, there is no clear consensus on the appropriate proximal resection margin distance to ensure negative margins, and the prognostic implications are unknown. PATIENTS AND

methodsThis retrospective study included 116 patients with Siewert type II/III EGJ adenocarcinoma who underwent lower esophagectomy with proximal or total gastrectomy. The parameter, delta proximal margin (ΔPM), was used to analyze the discrepancy between gross and pathological proximal margins, while ΔPM' accounted for shrinkage during formalin fixation. Margin recommendations were stratified by cancer stage and histological type, and long-term outcomes were analyzed using survival statistics.

resultsData for 109 patients were analyzed. Recommended gross resection margins ≥ 9 mm were necessary for early stage cancer, ≥ 15 mm for differentiated advanced cancer, and ≥ 21 mm for undifferentiated advanced cancer. Large tumor size (≥ 40 mm) was significantly associated with longer ΔPM' (p = 0.028). In advanced cancers, patients with a gross resection margin < 15 mm had significantly worse relapse-free survival than those with a gross resection margin ≥ 15 mm (p = 0.038). This margin cutoff was a significant prognostic factor in the multivariate analysis (p = 0.017).

conclusionsA gross proximal margin of at least 15 mm appears to reduce positive margins and confer survival advantage for advanced EGJ adenocarcinoma.

Indexed as

AdenocarcinomaEsophageal NeoplasmsEsophagectomyEsophagogastric JunctionGastrectomyMargins of ExcisionNeoplasm Recurrence, LocalStomach NeoplasmsAgedFemaleFollow-Up StudiesHumansLymph Node ExcisionMaleMiddle AgedNeoplasm StagingEsophagogastric junction cancerPrognosisProximal resection marginTranshiatal approachTumor size

Identifiers

PMID41538115

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