多模式治疗方案成为食管癌患者的护理标准，而手术切除仍然是治愈性治疗方式的核心。目前的指南没有提供关于口腔切除边缘范围的建议，特别是在新辅助治疗时代。因此，本研究旨在评估口腔无瘤切除边缘与总生存率之间的关系。对 2013 年至 2019 年间接受 Ivor-Lewis 食管切除术的 660 名患者中的 382 名 1:1 倾向匹配患者进行回顾性研究用于新辅助治疗后的食管或食管胃交界处的腺癌和鳞状细胞癌。独立病理学家在福尔马林固定后测量口腔切除边缘。平均口腔无肿瘤切除边缘为 37.2 ± 0.6 mm。生存差异的理想截止值确定为 33 毫米。口腔切除边缘超过 33 mm 的患者具有更好的中位总生存期（≤33 mm：45.0 个月，95% 置信区间：22.4-67.6 个月，>33 mm：未达到，P = .005）。多变量 Cox 回归分析证明，口腔切除边缘超过 33 mm 是患者总体生存的独立有利预后因素 (P = .049)。本研究回顾性分析了治疗性 Ivor-Lewis 食管切除术后的患者队列。新辅助治疗。超过 33 毫米的口腔切除边缘是提高总体生存率的一个因素。因此，建议固定后最小切除边缘为 34 mm。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

Multimodal therapy regimens became the standard of care for patients with esophageal cancer, whereas surgical resection remains at the center of curative treatment modalities. Current guidelines provide no recommendations on the extent of the oral resection margin, especially in the era of neoadjuvant therapy. Therefore, this study aimed to evaluate the relationship between the oral tumor-free resection margin and overall survival.Retrospective study with 382 1:1 propensity-matched patients out of 660 patients, operated between 2013 and 2019, with an Ivor-Lewis-esophagectomy for adenocarcinoma and squamous cell carcinoma of the esophagus or esophagogastric junction after neoadjuvant therapy. Independent pathologists measured the oral resection margin after formalin fixation.The mean oral tumor-free resection margin was 37.2 ± 0.6 mm. The ideal cut-off for survival differences was determined for 33 mm. Patients with an oral resection margin of more than 33 mm had a better median overall survival (≤33 mm: 45.0 months, 95% confidence interval: 22.4-67.6 months, >33 mm: not reached, P = .005). An oral resection margin of more than 33 mm proved to be an independent favorable prognostic factor for patients' overall survival in multivariate Cox regression analyses (P = .049).This study analyzed a patient cohort retrospectively after curative intended Ivor-Lewis-esophagectomy after neoadjuvant therapy. An oral resection margin of more than 33 mm is a factor for improved overall survival. Therefore, a minimum resection margin of 34 mm after fixation could be suggested.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.