Predictive factors of recurrence in adenocarcinoma of the esophagogastric junction in the multimodal era
Adenocarcinoma of the esophagogastric junction (AEGJ) represents a poor prognostic tumor. We evaluated the recurrence pattern and risk factors associated with recurrence in patients undergoing surgical resection by AEJG. Recurrences were categorized as locoregional, peritoneal, or distant. These thr...
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| Veröffentlicht in: | The American journal of surgery 2021-03, Vol.221 (3), p.631-636 |
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| creator | Takeda, Flavio Roberto Kodama Pertille Ramos, Marcus Fernando Pereira, Marina Alessandra Muniz, Renan Rosetti Tustumi, Francisco Biachi de Castria, Tiago Aissar Sallum, Rubens Antonio Zilberstein, Bruno Junior, Ulysses Ribeiro Cecconello, Ivan |
| description | Adenocarcinoma of the esophagogastric junction (AEGJ) represents a poor prognostic tumor. We evaluated the recurrence pattern and risk factors associated with recurrence in patients undergoing surgical resection by AEJG.
Recurrences were categorized as locoregional, peritoneal, or distant. These three recurrence groups and a non-recurrence group were compared, and overall survival (OS) and disease-free survival (DFS) for each one was obtained.
We analyzed 188 patients with curative surgical treatment. Recurrence was observed in 72 (38.3%) patients. Locoregional recurrence was observed in 17 (23.6%); 20 (27.8%) peritoneal recurrence and 35 (48.6%) distant metastasis. DFS was 9, 5, and 8 months, and OS was 21.8, 13.2, and 20.8, respectively. Tumors larger than 5 cm are risk factors for peritoneal recurrence (OR:2.88, p = 0.012). Positive lymph nodes were related to distant metastasis (OR:9.15, p = 0.040), and lymphatic invasion for locoregional recurrence (OR:3.81, p = 0.028).
AEGJ is associated with high rates of early recurrence.
•Recurrence in adenocarcinoma of the esophagogastric junction is related to a poor prognosis.•Distant metastases were more frequent, followed by peritoneal and locoregional.•Peritoneal recurrence and large tumors predict worst survival outcome after multivariable analysis. |
| doi_str_mv | 10.1016/j.amjsurg.2020.07.031 |
| format | Article |
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Recurrences were categorized as locoregional, peritoneal, or distant. These three recurrence groups and a non-recurrence group were compared, and overall survival (OS) and disease-free survival (DFS) for each one was obtained.
We analyzed 188 patients with curative surgical treatment. Recurrence was observed in 72 (38.3%) patients. Locoregional recurrence was observed in 17 (23.6%); 20 (27.8%) peritoneal recurrence and 35 (48.6%) distant metastasis. DFS was 9, 5, and 8 months, and OS was 21.8, 13.2, and 20.8, respectively. Tumors larger than 5 cm are risk factors for peritoneal recurrence (OR:2.88, p = 0.012). Positive lymph nodes were related to distant metastasis (OR:9.15, p = 0.040), and lymphatic invasion for locoregional recurrence (OR:3.81, p = 0.028).
AEGJ is associated with high rates of early recurrence.
•Recurrence in adenocarcinoma of the esophagogastric junction is related to a poor prognosis.•Distant metastases were more frequent, followed by peritoneal and locoregional.•Peritoneal recurrence and large tumors predict worst survival outcome after multivariable analysis.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2020.07.031</identifier><identifier>PMID: 32862976</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenocarcinoma ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - therapy ; Aged ; Cancer therapies ; Chemotherapy ; Combined Modality Therapy ; Disease-Free Survival ; Esophageal cancer ; Esophageal Neoplasms - mortality ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - therapy ; Esophagectomy ; Esophagogastric Junction ; Esophagus ; Female ; Gastrectomy ; Gastrointestinal surgery ; Humans ; Lymph nodes ; Lymphatic system ; Male ; Medical prognosis ; Metastases ; Metastasis ; Middle Aged ; Multivariate analysis ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - diagnosis ; Neoplasm Recurrence, Local - etiology ; Neoplasm Recurrence, Local - mortality ; Neoplasm Staging ; Peritoneum ; Prognosis ; Recurrence ; Retrospective Studies ; Risk analysis ; Risk Factors ; Survival ; Survival Rate ; Tumors</subject><ispartof>The American journal of surgery, 2021-03, Vol.221 (3), p.631-636</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-27c4d3652a20a0694be4a2292a7da2f3a493fcabb61b281deafb696d44e7ce873</citedby><cites>FETCH-LOGICAL-c393t-27c4d3652a20a0694be4a2292a7da2f3a493fcabb61b281deafb696d44e7ce873</cites><orcidid>0000-0002-6865-0988 ; 0000-0001-7338-922X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2502812726?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,64361,64363,64365,65309,72215</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32862976$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takeda, Flavio Roberto</creatorcontrib><creatorcontrib>Kodama Pertille Ramos, Marcus Fernando</creatorcontrib><creatorcontrib>Pereira, Marina Alessandra</creatorcontrib><creatorcontrib>Muniz, Renan Rosetti</creatorcontrib><creatorcontrib>Tustumi, Francisco</creatorcontrib><creatorcontrib>Biachi de Castria, Tiago</creatorcontrib><creatorcontrib>Aissar Sallum, Rubens Antonio</creatorcontrib><creatorcontrib>Zilberstein, Bruno</creatorcontrib><creatorcontrib>Junior, Ulysses Ribeiro</creatorcontrib><creatorcontrib>Cecconello, Ivan</creatorcontrib><title>Predictive factors of recurrence in adenocarcinoma of the esophagogastric junction in the multimodal era</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Adenocarcinoma of the esophagogastric junction (AEGJ) represents a poor prognostic tumor. We evaluated the recurrence pattern and risk factors associated with recurrence in patients undergoing surgical resection by AEJG.
Recurrences were categorized as locoregional, peritoneal, or distant. These three recurrence groups and a non-recurrence group were compared, and overall survival (OS) and disease-free survival (DFS) for each one was obtained.
We analyzed 188 patients with curative surgical treatment. Recurrence was observed in 72 (38.3%) patients. Locoregional recurrence was observed in 17 (23.6%); 20 (27.8%) peritoneal recurrence and 35 (48.6%) distant metastasis. DFS was 9, 5, and 8 months, and OS was 21.8, 13.2, and 20.8, respectively. Tumors larger than 5 cm are risk factors for peritoneal recurrence (OR:2.88, p = 0.012). Positive lymph nodes were related to distant metastasis (OR:9.15, p = 0.040), and lymphatic invasion for locoregional recurrence (OR:3.81, p = 0.028).
AEGJ is associated with high rates of early recurrence.
•Recurrence in adenocarcinoma of the esophagogastric junction is related to a poor prognosis.•Distant metastases were more frequent, followed by peritoneal and locoregional.•Peritoneal recurrence and large tumors predict worst survival outcome after multivariable analysis.</description><subject>Adenocarcinoma</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - therapy</subject><subject>Aged</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Combined Modality Therapy</subject><subject>Disease-Free Survival</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - mortality</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - therapy</subject><subject>Esophagectomy</subject><subject>Esophagogastric Junction</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - diagnosis</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Staging</subject><subject>Peritoneum</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Tumors</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkU9r3DAQxUVpSbZpPkKDoZdc7OiPV7JOoYSmLQSSQ3oWY2m8K2NbG8kO9NtXZrc59NLTIOb33oj3CPnMaMUokzd9BWOflrirOOW0oqqigr0jG9YoXbKmEe_JhlLKSy0ZPScfU-rzk7FanJFzwRvJtZIbsn-K6Lyd_SsWHdg5xFSEroholxhxslj4qQCHU7AQrZ_CCOt-3mOBKRz2sAs7SHP0tuiXKfuEaVWs-3EZZj8GB0OBET6RDx0MCS9P84L8uv_2fPejfHj8_vPu60NphRZzyZWtnZBbDpwClbpusQbONQflgHcCai06C20rWcsb5hC6Vmrp6hqVxUaJC3J99D3E8LJgms3ok8VhgAnDkgyvRaM1VbLJ6Jd_0D4sccq_M3xLsztXXGZqe6RsDClF7Mwh-hHib8OoWaswvTlVYdYqDFUmV5F1Vyf3pR3Rvan-Zp-B2yOAOY5Xj9Ek69fInc_xz8YF_58TfwBN3Z5z</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Takeda, Flavio Roberto</creator><creator>Kodama Pertille Ramos, Marcus Fernando</creator><creator>Pereira, Marina Alessandra</creator><creator>Muniz, Renan Rosetti</creator><creator>Tustumi, Francisco</creator><creator>Biachi de Castria, Tiago</creator><creator>Aissar Sallum, Rubens Antonio</creator><creator>Zilberstein, Bruno</creator><creator>Junior, Ulysses Ribeiro</creator><creator>Cecconello, Ivan</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6865-0988</orcidid><orcidid>https://orcid.org/0000-0001-7338-922X</orcidid></search><sort><creationdate>202103</creationdate><title>Predictive factors of recurrence in adenocarcinoma of the esophagogastric junction in the multimodal era</title><author>Takeda, Flavio Roberto ; Kodama Pertille Ramos, Marcus Fernando ; Pereira, Marina Alessandra ; Muniz, Renan Rosetti ; Tustumi, Francisco ; Biachi de Castria, Tiago ; Aissar Sallum, Rubens Antonio ; Zilberstein, Bruno ; Junior, Ulysses Ribeiro ; Cecconello, Ivan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-27c4d3652a20a0694be4a2292a7da2f3a493fcabb61b281deafb696d44e7ce873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adenocarcinoma</topic><topic>Adenocarcinoma - 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Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takeda, Flavio Roberto</au><au>Kodama Pertille Ramos, Marcus Fernando</au><au>Pereira, Marina Alessandra</au><au>Muniz, Renan Rosetti</au><au>Tustumi, Francisco</au><au>Biachi de Castria, Tiago</au><au>Aissar Sallum, Rubens Antonio</au><au>Zilberstein, Bruno</au><au>Junior, Ulysses Ribeiro</au><au>Cecconello, Ivan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive factors of recurrence in adenocarcinoma of the esophagogastric junction in the multimodal era</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2021-03</date><risdate>2021</risdate><volume>221</volume><issue>3</issue><spage>631</spage><epage>636</epage><pages>631-636</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Adenocarcinoma of the esophagogastric junction (AEGJ) represents a poor prognostic tumor. We evaluated the recurrence pattern and risk factors associated with recurrence in patients undergoing surgical resection by AEJG.
Recurrences were categorized as locoregional, peritoneal, or distant. These three recurrence groups and a non-recurrence group were compared, and overall survival (OS) and disease-free survival (DFS) for each one was obtained.
We analyzed 188 patients with curative surgical treatment. Recurrence was observed in 72 (38.3%) patients. Locoregional recurrence was observed in 17 (23.6%); 20 (27.8%) peritoneal recurrence and 35 (48.6%) distant metastasis. DFS was 9, 5, and 8 months, and OS was 21.8, 13.2, and 20.8, respectively. Tumors larger than 5 cm are risk factors for peritoneal recurrence (OR:2.88, p = 0.012). Positive lymph nodes were related to distant metastasis (OR:9.15, p = 0.040), and lymphatic invasion for locoregional recurrence (OR:3.81, p = 0.028).
AEGJ is associated with high rates of early recurrence.
•Recurrence in adenocarcinoma of the esophagogastric junction is related to a poor prognosis.•Distant metastases were more frequent, followed by peritoneal and locoregional.•Peritoneal recurrence and large tumors predict worst survival outcome after multivariable analysis.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32862976</pmid><doi>10.1016/j.amjsurg.2020.07.031</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-6865-0988</orcidid><orcidid>https://orcid.org/0000-0001-7338-922X</orcidid></addata></record> |
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| subjects | Adenocarcinoma Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - therapy Aged Cancer therapies Chemotherapy Combined Modality Therapy Disease-Free Survival Esophageal cancer Esophageal Neoplasms - mortality Esophageal Neoplasms - pathology Esophageal Neoplasms - therapy Esophagectomy Esophagogastric Junction Esophagus Female Gastrectomy Gastrointestinal surgery Humans Lymph nodes Lymphatic system Male Medical prognosis Metastases Metastasis Middle Aged Multivariate analysis Neoplasm Invasiveness Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - etiology Neoplasm Recurrence, Local - mortality Neoplasm Staging Peritoneum Prognosis Recurrence Retrospective Studies Risk analysis Risk Factors Survival Survival Rate Tumors |
| title | Predictive factors of recurrence in adenocarcinoma of the esophagogastric junction in the multimodal era |
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