Prevention and treatment of a positive proximal margin after gastrectomy for cardia cancer

Updates Surg. 2023 Feb;75(2):335-341. doi: 10.1007/s13304-022-01315-4. Epub 2022 Jul 16.

Abstract

A tumour-positive proximal margin (PPM) after extended gastrectomy for oesophagogastric junction (OGJ) adenocarcinoma is observed in approximately 2-20% of patients. Although a PPM is an unfavourable prognostic factor, the clinical relevance remains unclear as it may reflect poor tumour biology. This narrative review analyses the most relevant literature on PPM after gastrectomy for OGJ cancers. Awareness of the risk factors and possible measures that can be taken to reduce the risk of PPM are important. In patients with a PPM, surgical and non-surgical treatments are available but the effectiveness remains unclear.

Keywords: Cardia cancer; Extended total gastrectomy; Junctional adenocarcinoma; Positive resection margin; R1.

Publication types

  • Review

MeSH terms

  • Cardia* / pathology
  • Cardia* / surgery
  • Esophagogastric Junction / pathology
  • Esophagogastric Junction / surgery
  • Gastrectomy
  • Humans
  • Margins of Excision
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / surgery

Supplementary concepts

  • Adenocarcinoma Of Esophagus