BACKGROUND: A proximal margin distance of 5  cm is advocated for resection of @entity356 ( @entity356 ). We assessed the prognostic value of proximal margin (PM) distance on survival outcomes after resection of distal @entity356 . METHODS: All @entity1 who underwent resection of distal @entity356 (antrum/body) from 2000 to 2012 at seven institutions of the U.S. @entity356 Collaborative were included. @entity1 with positive distal margins or macroscopic residual disease were excluded. The prognostic value of PM distance (assessed in 0.5-cm increments) on overall ( @entity3012 ) and recurrence-free survival (RFS) was assessed by Kaplan-Meier and multivariate regression analysis. RESULTS: A total of 465 @entity1 underwent resection of distal @entity356 . Of these, 435 had R0 resections; 30 @entity1 had a positive PM. 143 @entity1 had stage I, and 322 had @entity5 . Median follow-up was 44  months. Average PM distance was 4.8  cm. Median @entity3012 for @entity1 with PM of 3.1-5.0  cm (n  =  110) was superior to @entity1 with PM   <=  3.0  cm (n  =  176) (48.1 vs. 29.3  months; p  =  0.01), while a margin >5.0  cm (n  =  179) offered equivalent survival to PM 3.1-5.0  cm (50.6  months, p  =  0.72). The prognostic value of margin distance was stage specific. On multivariate analysis of stage I @entity1 , PM 3.1-5.0  cm remained associated with improved @entity3012 [hazard ratio (HR), 0.16; 95  % confidence interval (95  % CI), 0.04-0.60; p  =  0.01]. In stage II-III, neither PM 3.1-5.0  cm nor PM  >  5.0  cm was significantly associated with @entity3012 ; @entity3012 was dictated by T stage and nodal involvement. CONCLUSIONS: The prognostic value of proximal margin distance after resection of distal @entity356 appears stage specific. In stage I, a 3.1- to 5.0-cm proximal margin is associated with the same improved @entity3012 as a  >  5.0-cm margin. In @entity5 , other adverse pathologic factors more strongly impact survival than proximal margin distance.

Is It Time to Abandon the 5-cm Margin Rule During Resection of Distal @entity356 ? A Multi-Institution Study of the U.S. XXXX Collaborative.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['stage II-III disease', 'stage II-III tumors'] @entity356 :: ('MESH:D013274', 'Disease') :: ['GAC', 'gastric cancer', 'Gastric Cancer', 'gastric adenocarcinoma'] @entity3012 :: ('MESH:C567932', 'Disease') :: ['OS']
@entity356 :: (MESH:D013274,Disease) :: ['Gastric Cancer']
