Clinicopathological Features and Prognostic Factors of Adenocarcinoma of the Esophagogastric Junction According to Siewert Classification: Experiences at a Single Institution in Japan
Background Treatment strategy for adenocarcinoma of the esophagogastric junction (AEG) remains controversial. The aims of this study are to evaluate results of surgery for AEG, to clarify clinicopathological differences according to the Siewert classification, and to define prognostic factors. Metho...
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| Veröffentlicht in: | Annals of surgical oncology 2012-02, Vol.19 (2), p.677-683 |
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| creator | Hosokawa, Yuichi Kinoshita, Takahiro Konishi, Masaru Takahashi, Shinichiro Gotohda, Naoto Kato, Yuichiro Daiko, Hiroyuki Nishimura, Mitsuyo Katsumata, Kenji Sugiyama, Yasuyuki Kinoshita, Taira |
| description | Background
Treatment strategy for adenocarcinoma of the esophagogastric junction (AEG) remains controversial. The aims of this study are to evaluate results of surgery for AEG, to clarify clinicopathological differences according to the Siewert classification, and to define prognostic factors.
Methods
We retrospectively analyzed 179 consecutive patients with Siewert type I, II, and III AEG who underwent curative (R0) resection at the National Cancer Center Hospital East between January 1993 and December 2008.
Results
Patients with AEG were divided according to tumor: 10 type I (5.6%), 107 type II (59.8%), and 62 type III (34.6%). Larger, deeper tumors and nodal metastasis were more common in type III than type II tumors. No significant differences were seen in 5-year survival rates among the three types: type I (51.4%), type II (51.8%), and type III (62.6%). Multivariate analysis showed that depth of tumor and mediastinal lymph node metastasis were independent prognostic indicators. The recurrence rate for patients with mediastinal lymph node metastasis was 87.5%. The risk factors for mediastinal lymph node metastasis were length of esophageal invasion and histopathological grade.
Conclusions
Mediastinal lymph node metastasis and tumor depth were significant and independent factors for poor prognosis after R0 resection for AEG. Esophageal invasion and histopathological grade were significant and independent factors for mediastinal lymph node metastasis. |
| doi_str_mv | 10.1245/s10434-011-1983-x |
| format | Article |
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Treatment strategy for adenocarcinoma of the esophagogastric junction (AEG) remains controversial. The aims of this study are to evaluate results of surgery for AEG, to clarify clinicopathological differences according to the Siewert classification, and to define prognostic factors.
Methods
We retrospectively analyzed 179 consecutive patients with Siewert type I, II, and III AEG who underwent curative (R0) resection at the National Cancer Center Hospital East between January 1993 and December 2008.
Results
Patients with AEG were divided according to tumor: 10 type I (5.6%), 107 type II (59.8%), and 62 type III (34.6%). Larger, deeper tumors and nodal metastasis were more common in type III than type II tumors. No significant differences were seen in 5-year survival rates among the three types: type I (51.4%), type II (51.8%), and type III (62.6%). Multivariate analysis showed that depth of tumor and mediastinal lymph node metastasis were independent prognostic indicators. The recurrence rate for patients with mediastinal lymph node metastasis was 87.5%. The risk factors for mediastinal lymph node metastasis were length of esophageal invasion and histopathological grade.
Conclusions
Mediastinal lymph node metastasis and tumor depth were significant and independent factors for poor prognosis after R0 resection for AEG. Esophageal invasion and histopathological grade were significant and independent factors for mediastinal lymph node metastasis.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-011-1983-x</identifier><identifier>PMID: 21822549</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Esophageal Neoplasms - mortality ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - surgery ; Esophagogastric Junction - pathology ; Female ; Follow-Up Studies ; Humans ; Japan ; Lymphatic Metastasis ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Neoplasm Staging ; Oncology ; Prognosis ; Retrospective Studies ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Surgery ; Surgical Oncology ; Survival Rate ; Thoracic Oncology</subject><ispartof>Annals of surgical oncology, 2012-02, Vol.19 (2), p.677-683</ispartof><rights>Society of Surgical Oncology 2011</rights><rights>Society of Surgical Oncology 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-4fc55ba18b5212cb9c6951369fb857a0657c388a1bc81eac1345c6943da01bb13</citedby><cites>FETCH-LOGICAL-c436t-4fc55ba18b5212cb9c6951369fb857a0657c388a1bc81eac1345c6943da01bb13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-011-1983-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-011-1983-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21822549$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hosokawa, Yuichi</creatorcontrib><creatorcontrib>Kinoshita, Takahiro</creatorcontrib><creatorcontrib>Konishi, Masaru</creatorcontrib><creatorcontrib>Takahashi, Shinichiro</creatorcontrib><creatorcontrib>Gotohda, Naoto</creatorcontrib><creatorcontrib>Kato, Yuichiro</creatorcontrib><creatorcontrib>Daiko, Hiroyuki</creatorcontrib><creatorcontrib>Nishimura, Mitsuyo</creatorcontrib><creatorcontrib>Katsumata, Kenji</creatorcontrib><creatorcontrib>Sugiyama, Yasuyuki</creatorcontrib><creatorcontrib>Kinoshita, Taira</creatorcontrib><title>Clinicopathological Features and Prognostic Factors of Adenocarcinoma of the Esophagogastric Junction According to Siewert Classification: Experiences at a Single Institution in Japan</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Treatment strategy for adenocarcinoma of the esophagogastric junction (AEG) remains controversial. The aims of this study are to evaluate results of surgery for AEG, to clarify clinicopathological differences according to the Siewert classification, and to define prognostic factors.
Methods
We retrospectively analyzed 179 consecutive patients with Siewert type I, II, and III AEG who underwent curative (R0) resection at the National Cancer Center Hospital East between January 1993 and December 2008.
Results
Patients with AEG were divided according to tumor: 10 type I (5.6%), 107 type II (59.8%), and 62 type III (34.6%). Larger, deeper tumors and nodal metastasis were more common in type III than type II tumors. No significant differences were seen in 5-year survival rates among the three types: type I (51.4%), type II (51.8%), and type III (62.6%). Multivariate analysis showed that depth of tumor and mediastinal lymph node metastasis were independent prognostic indicators. The recurrence rate for patients with mediastinal lymph node metastasis was 87.5%. The risk factors for mediastinal lymph node metastasis were length of esophageal invasion and histopathological grade.
Conclusions
Mediastinal lymph node metastasis and tumor depth were significant and independent factors for poor prognosis after R0 resection for AEG. Esophageal invasion and histopathological grade were significant and independent factors for mediastinal lymph node metastasis.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Esophageal Neoplasms - mortality</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagogastric Junction - pathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Japan</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Thoracic Oncology</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kV-L1DAUxYso7rr6AXyR4ItP1dz8aVPfhmFGd1lQUJ_LbZp2snSSmqQ4fjK_nqmzKgg-3cvN75wTOEXxHOhrYEK-iUAFFyUFKKFRvDw9KC5B5ouoFDzMO61U2bBKXhRPYryjFGpO5ePigoFiTIrmsvixnayz2s-YDn7yo9U4kb3BtAQTCbqefAx-dD4mq8kedfIhEj-QTW-c1xi0df6I6yUdDNlFPx9w9CPGFLLgZnE6We_IRmsfeutGkjz5ZM03ExLZThijHXLkyrwlu9NsgjVOr8mJYAbdOBly7XJ6Wn4ZWUducEb3tHg04BTNs_t5VXzZ7z5v35e3H95dbze3pRa8SqUYtJQdguokA6a7RleNBF41Q6dkjbSSteZKIXRagUENXMiMCN4jha4DflW8OvvOwX9dTEzt0UZtpgmd8UtsG6iVFILzTL78h7zzS3D5cyvEQQGrMwRnSAcfYzBDOwd7xPC9BdqunbbnTtvcabt22p6y5sW98dIdTf9H8bvEDLAzEPOTG034m_x_15-abbCN</recordid><startdate>20120201</startdate><enddate>20120201</enddate><creator>Hosokawa, Yuichi</creator><creator>Kinoshita, Takahiro</creator><creator>Konishi, Masaru</creator><creator>Takahashi, Shinichiro</creator><creator>Gotohda, Naoto</creator><creator>Kato, Yuichiro</creator><creator>Daiko, Hiroyuki</creator><creator>Nishimura, Mitsuyo</creator><creator>Katsumata, Kenji</creator><creator>Sugiyama, Yasuyuki</creator><creator>Kinoshita, Taira</creator><general>Springer-Verlag</general><general>Springer Nature B.V</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>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20120201</creationdate><title>Clinicopathological Features and Prognostic Factors of Adenocarcinoma of the Esophagogastric Junction According to Siewert Classification: Experiences at a Single Institution in Japan</title><author>Hosokawa, Yuichi ; Kinoshita, Takahiro ; Konishi, Masaru ; Takahashi, Shinichiro ; Gotohda, Naoto ; Kato, Yuichiro ; Daiko, Hiroyuki ; Nishimura, Mitsuyo ; Katsumata, Kenji ; Sugiyama, Yasuyuki ; Kinoshita, Taira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-4fc55ba18b5212cb9c6951369fb857a0657c388a1bc81eac1345c6943da01bb13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Esophageal Neoplasms - mortality</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Esophagogastric Junction - pathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Japan</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Thoracic Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hosokawa, Yuichi</creatorcontrib><creatorcontrib>Kinoshita, Takahiro</creatorcontrib><creatorcontrib>Konishi, Masaru</creatorcontrib><creatorcontrib>Takahashi, Shinichiro</creatorcontrib><creatorcontrib>Gotohda, Naoto</creatorcontrib><creatorcontrib>Kato, Yuichiro</creatorcontrib><creatorcontrib>Daiko, Hiroyuki</creatorcontrib><creatorcontrib>Nishimura, Mitsuyo</creatorcontrib><creatorcontrib>Katsumata, Kenji</creatorcontrib><creatorcontrib>Sugiyama, Yasuyuki</creatorcontrib><creatorcontrib>Kinoshita, Taira</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hosokawa, Yuichi</au><au>Kinoshita, Takahiro</au><au>Konishi, Masaru</au><au>Takahashi, Shinichiro</au><au>Gotohda, Naoto</au><au>Kato, Yuichiro</au><au>Daiko, Hiroyuki</au><au>Nishimura, Mitsuyo</au><au>Katsumata, Kenji</au><au>Sugiyama, Yasuyuki</au><au>Kinoshita, Taira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinicopathological Features and Prognostic Factors of Adenocarcinoma of the Esophagogastric Junction According to Siewert Classification: Experiences at a Single Institution in Japan</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2012-02-01</date><risdate>2012</risdate><volume>19</volume><issue>2</issue><spage>677</spage><epage>683</epage><pages>677-683</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Treatment strategy for adenocarcinoma of the esophagogastric junction (AEG) remains controversial. The aims of this study are to evaluate results of surgery for AEG, to clarify clinicopathological differences according to the Siewert classification, and to define prognostic factors.
Methods
We retrospectively analyzed 179 consecutive patients with Siewert type I, II, and III AEG who underwent curative (R0) resection at the National Cancer Center Hospital East between January 1993 and December 2008.
Results
Patients with AEG were divided according to tumor: 10 type I (5.6%), 107 type II (59.8%), and 62 type III (34.6%). Larger, deeper tumors and nodal metastasis were more common in type III than type II tumors. No significant differences were seen in 5-year survival rates among the three types: type I (51.4%), type II (51.8%), and type III (62.6%). Multivariate analysis showed that depth of tumor and mediastinal lymph node metastasis were independent prognostic indicators. The recurrence rate for patients with mediastinal lymph node metastasis was 87.5%. The risk factors for mediastinal lymph node metastasis were length of esophageal invasion and histopathological grade.
Conclusions
Mediastinal lymph node metastasis and tumor depth were significant and independent factors for poor prognosis after R0 resection for AEG. Esophageal invasion and histopathological grade were significant and independent factors for mediastinal lymph node metastasis.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>21822549</pmid><doi>10.1245/s10434-011-1983-x</doi><tpages>7</tpages></addata></record> |
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| ispartof | Annals of surgical oncology, 2012-02, Vol.19 (2), p.677-683 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Aged, 80 and over Esophageal Neoplasms - mortality Esophageal Neoplasms - pathology Esophageal Neoplasms - surgery Esophagogastric Junction - pathology Female Follow-Up Studies Humans Japan Lymphatic Metastasis Male Medicine Medicine & Public Health Middle Aged Neoplasm Invasiveness Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Neoplasm Staging Oncology Prognosis Retrospective Studies Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - surgery Surgery Surgical Oncology Survival Rate Thoracic Oncology |
| title | Clinicopathological Features and Prognostic Factors of Adenocarcinoma of the Esophagogastric Junction According to Siewert Classification: Experiences at a Single Institution in Japan |
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