为了获得胃癌合并肿瘤侵犯食管或食管胃交界处癌症的病理阴性近端切缘（PM），我们需要在肿瘤与病理学界限不符合的情况下，将食管切断至超越肿瘤近端界面的安全距离。然而，这些癌症的食管切除长度的推荐尚未确定。接受胃癌近端或全胃切除手术的患者均被纳入研究中。评估了参数ΔPM，该参数对应肿瘤近端界面的肿瘤大小和生长方式之间的差异长度。首先，确定了所有患者中最大的ΔPM，该参数对应最小切除距离以确保病理阴性PM。然后，根据与ΔPM≥10mm有关的因素进行亚组分析，以确定替代的最大ΔPM。共有289例胃癌合并肿瘤侵犯食管或食管胃交界处癌症的患者符合资格并参与了本研究。最大ΔPM为25mm。临床肿瘤（c肿瘤）大小和生长以及病理类型与ΔPM≥10mm独立相关。在亚组分析中，c肿瘤大小≤40mm的浅表型生长类型的最大ΔPM为15mm。此外，扩张型生长类型的最大ΔPM为20mm。我们提出了确保胃癌合并肿瘤侵犯食管或食管胃交界处癌症的病理阴性PM所需的食管切除长度。©2023年作者在国际胃癌协会和日本胃癌协会的专属许可下发表。

To obtain a pathologically negative proximal margin (PM) for gastric cancer with gross esophageal invasion (EI) or esophagogastric junction (EGJ) cancer, we should transect the esophagus beyond the proximal boundary of gross EI with a safety margin because of a discrepancy between the gross and pathological boundaries of cancer. However, recommendations regarding the esophageal resection length for these cancers have not been established.Patients who underwent proximal or total gastrectomy for gastric cancer with gross EI or EGJ cancer were enrolled. A parameter ΔPM, which corresponded to the length of a discrepancy between the gross and pathological proximal boundary of the tumor, was evaluated. The maximum ΔPM, which corresponded to the minimum length ensuring a pathologically negative PM, was first determined in all patients. Then subgroup analyses according to factors associated with ΔPM ≥ 10 mm were performed to identify alternative maximum ΔPMs.A total of 289 patients with gastric cancer with gross EI or EGJ cancer were eligible and analyzed in this study. The maximum ΔPM was 25 mm. Clinical tumor (cTumor) size and growth and pathological types were independently associated with ΔPM ≥ 10 mm. In subgroup analyses, the maximum ΔPM was 15 mm for cTumor size ≤ 40 mm and superficial growth type. Furthermore, the maximum ΔPM was 20 mm in the expansive growth type.Required esophageal resection lengths to ensure a pathologically negative PM for gastric cancer with gross EI or EGJ cancer are proposed.© 2023. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.