| Objective: To discuss the positive margin rate on the survival rate after cardiac effects of adenovirus and to explore the impact of positive rate margin factor.Methods: Since the Court in January 2002 to Octomber 2008 abdominal surgery treatment in patients with adenocarcinoma of the cardia, Siewert classification as typeâ…¡,â…¢type, a total of 117 cases, of which 88 cases of male, female 29 cases, age 31 ~ 86 years old, median age 66 years old, 60-year-old and below 62 cases, 60 to 69 years 40 cases, 70-year-old and over 15 cases. Preoperative B patients had abdominal ultrasound, chest CT (or abdominal CT), upper gastrointestinal endoscopy and angiography to identify whether the surgery and how surgery. All patients received surgical treatment: radical surgery of which 110 cases, seven cases of palliative resection. Abdominal lymph node dissection of 2347, intra-abdominal lymph node metastasis rate of 82.9%, esophageal tumor margin from an average of 3cm, esophageal resection margin-positive cases of 10 cases, positive rate of 9.1%. According to International Union Against Cancer (IGCA) phases,:â… A period of four cases,â… B Phase 2 cases,â…¡period of 18 cases,â…¢A 27 cases,â…¢B 30 cases,â…£period 36 cases. The use of letters and telephone follow-up period of follow-up 1-5, the follow-up rate of 86.4%, 1-year survival rate of 93.64%, 2-year survival rate of 82.29%, 3-year survival rate of 66.59%, 5-year survival rate of 35.41%.Results: 1 margin on the patients 1 year and 3-year survival rate was significantly lower than that in patients with non-positive. Margin-negative patients with 1-year survival rate of 91%, 3 years was 67%, and positive patients were 30%, 10%.Analysis of impact on the rate of margin-positive factors, T1 tumors were negative on the margin. T2-T4 tumors positive rate close to, statistical analysis, P> 0.05, T2-T4 tumors positive rate on the same margin. From the point of view of the degree of differentiation, well-differentiated and differentiated on the margin are negative, poorly differentiated on the positive margin rate was 12%. Margin of tumor size on the impact of positive rate, of different sizes have positive tumors, statistical analysis, P> 0.05, tumor size of the positive margin rate of the same. On the cutting edge of the distance from the tumor> 3cm without positive patients occurred in the tumor margin distance of 3cm and less than 3cm from the patients.Conclusion: The positive margin to reduce the survival rate of patients. The degree of differentiation of the tumor the lower the positive margin occurred in the greater probability. Deeper tumor invasion, the greater the risk of margin-positive, as long as the invasion through submucosa, the risk of greatly increased penetration with the same treatment as full-thickness. Tumor size on the margin there is no significant positive impact. As for the length of resection for advanced tumors should be at least the length of 3cm, and intraoperative pathological to be done quickly.
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