title: The length of proximal margin does not influence the prognosis of Siewert type II/III adenocarcinoma of esophagogastric junction after transhiatal curative gastrectomy.
abstract: BACKGROUND
  The optimal length of proximal margin for Siewert type II/III adenocarcinoma of the esophagogastric junction (AEJ) is still need to be clarified. The aim of the present study was to investigate the appropriate length of proximal margin for Siewert type II/III AEJ through transhiatal approach.
  
  
  METHODS
  From September 2009 to December 2014, a total of 693 consecutive patients with Siewert type II/III AEJ were retrospectively analyzed. All patients received transhiatal R0 resection. The proximal margin length was measured immediately after resection. The prognostic value of proximal margin length on Siewert type II/III AEJ with transhiatal approach was analyzed.
  
  
  RESULTS
  There were 404 cases of Siewert type II AEJ (58.3 %) and 289 cases of Siewert type III AEJ (41.7 %). Total gastrectomy was performed in 526 patients (75.9 %), and proximal gastrectomy was performed in 167 patients (24.1 %). The median length of the gross proximal margin was 2.4 (range 0.1-5.0) cm. Lymph node metastasis was the only independent prognostic predictor for Siewert type II AEJ. Tumor size and lymph node metastasis were independent prognostic predictors for Siewert type III AEJ.
  
  
  CONCLUSIONS
  For Siewert type II/III AEJ with esophageal invasion of 3 cm or less, proximal margin length does not influence the prognosis of patients after transhiatal curative gastrectomy.
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Fan
authors.initials: F
authors.lastname: Feng
authors.affiliation: Department of Dermatology, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Yangzi
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Guanghui
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Shushang
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Gaozan
authors.initials: G
authors.lastname: Zheng
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Man
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Lian
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Daiming
authors.initials: D
authors.lastname: Fan
authors.affiliation: Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, 127 West Changle Road, Xi'an, 710032 Shaanxi China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhang
keywords: Adenocarcinoma of esophagogastric junction; Prognosis; Proximal margin; Siewert type