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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2012

01-02-2012 | Thoracic Oncology

Clinicopathological Features and Prognostic Factors of Adenocarcinoma of the Esophagogastric Junction According to Siewert Classification: Experiences at a Single Institution in Japan

Authors: Yuichi Hosokawa, MD, Takahiro Kinoshita, PhD, Masaru Konishi, MD, Shinichiro Takahashi, PhD, Naoto Gotohda, PhD, Yuichiro Kato, MD, Hiroyuki Daiko, MD, Mitsuyo Nishimura, MD, Kenji Katsumata, PhD, Yasuyuki Sugiyama, PhD, Taira Kinoshita, PhD

Published in: Annals of Surgical Oncology | Issue 2/2012

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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.
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Metadata
Title
Clinicopathological Features and Prognostic Factors of Adenocarcinoma of the Esophagogastric Junction According to Siewert Classification: Experiences at a Single Institution in Japan
Authors
Yuichi Hosokawa, MD
Takahiro Kinoshita, PhD
Masaru Konishi, MD
Shinichiro Takahashi, PhD
Naoto Gotohda, PhD
Yuichiro Kato, MD
Hiroyuki Daiko, MD
Mitsuyo Nishimura, MD
Kenji Katsumata, PhD
Yasuyuki Sugiyama, PhD
Taira Kinoshita, PhD
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1983-x

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