Clinicopathological Characteristics and Prognostic Factors of Patients with Siewert Type II Esophagogastric Junction Carcinoma: A Retrospective Multicenter Study

Tatsuo Matsuda, Yukinori Kurokawa, Takaki Yoshikawa, Kentaro Kishi, Kazunari Misawa, Masaki Ohi, Shinji Mine, Naoki Hiki, Hiroya Takeuchi

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Abstract

Background: The incidence of esophagogastric junction (EGJ) carcinoma is increasing, but its optimal surgical management remains controversial. Methods: We retrospectively reviewed the database of 400 patients with Siewert type II EGJ carcinoma who were treated surgically at 7 institutions between March 1986 and October 2010. We examined the clinicopathological characteristics, prognostic factors, and risk factors associated with each recurrence pattern. Results: The 5-year overall survival rate of all patients with Siewert type II EGJ carcinoma was 58.4 %. Multivariate analysis showed that T and N stages were independent prognostic factors. We also found that the incidence of lower mediastinal lymph node metastasis (17.7 %) and para-aortic lymph node metastasis (16.1 %) was relatively high. In addition, the para-aortic lymph nodes (N = 39, 9.8 %) were the most frequent node recurrence site, followed by the mediastinal lymph nodes (N = 23, 5.8 %). Lung recurrence was more common than was peritoneal recurrence. Considering each type of recurrence, multivariate analysis showed that the differentiated type was associated with a higher risk of lung recurrence than was the undifferentiated type, and N stage (pN2–3) and positive venous invasion were independent risk factors for liver recurrence. Conclusions: This study is one of the largest retrospective studies to evaluate patients with Siewert type II EGJ carcinoma. Para-aortic and mediastinal lymph node metastasis and recurrence rates were relatively high. During the postoperative follow-up of patients with differentiated Siewert type II EGJ carcinoma, patients should be monitored for lung recurrence more closely than that for peritoneal recurrence.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalWorld Journal of Surgery
DOIs
Publication statusAccepted/In press - 2016 Feb 29

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Esophagogastric Junction
Multicenter Studies
Retrospective Studies
Carcinoma
Recurrence
Lymph Nodes
Neoplasm Metastasis
Lung
Multivariate Analysis
Incidence
Survival Rate
Databases

ASJC Scopus subject areas

  • Surgery

Cite this

Clinicopathological Characteristics and Prognostic Factors of Patients with Siewert Type II Esophagogastric Junction Carcinoma : A Retrospective Multicenter Study. / Matsuda, Tatsuo; Kurokawa, Yukinori; Yoshikawa, Takaki; Kishi, Kentaro; Misawa, Kazunari; Ohi, Masaki; Mine, Shinji; Hiki, Naoki; Takeuchi, Hiroya.

In: World Journal of Surgery, 29.02.2016, p. 1-8.

Research output: Contribution to journalArticle

Matsuda, Tatsuo ; Kurokawa, Yukinori ; Yoshikawa, Takaki ; Kishi, Kentaro ; Misawa, Kazunari ; Ohi, Masaki ; Mine, Shinji ; Hiki, Naoki ; Takeuchi, Hiroya. / Clinicopathological Characteristics and Prognostic Factors of Patients with Siewert Type II Esophagogastric Junction Carcinoma : A Retrospective Multicenter Study. In: World Journal of Surgery. 2016 ; pp. 1-8.
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abstract = "Background: The incidence of esophagogastric junction (EGJ) carcinoma is increasing, but its optimal surgical management remains controversial. Methods: We retrospectively reviewed the database of 400 patients with Siewert type II EGJ carcinoma who were treated surgically at 7 institutions between March 1986 and October 2010. We examined the clinicopathological characteristics, prognostic factors, and risk factors associated with each recurrence pattern. Results: The 5-year overall survival rate of all patients with Siewert type II EGJ carcinoma was 58.4 {\%}. Multivariate analysis showed that T and N stages were independent prognostic factors. We also found that the incidence of lower mediastinal lymph node metastasis (17.7 {\%}) and para-aortic lymph node metastasis (16.1 {\%}) was relatively high. In addition, the para-aortic lymph nodes (N = 39, 9.8 {\%}) were the most frequent node recurrence site, followed by the mediastinal lymph nodes (N = 23, 5.8 {\%}). Lung recurrence was more common than was peritoneal recurrence. Considering each type of recurrence, multivariate analysis showed that the differentiated type was associated with a higher risk of lung recurrence than was the undifferentiated type, and N stage (pN2–3) and positive venous invasion were independent risk factors for liver recurrence. Conclusions: This study is one of the largest retrospective studies to evaluate patients with Siewert type II EGJ carcinoma. Para-aortic and mediastinal lymph node metastasis and recurrence rates were relatively high. During the postoperative follow-up of patients with differentiated Siewert type II EGJ carcinoma, patients should be monitored for lung recurrence more closely than that for peritoneal recurrence.",
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AU - Yoshikawa, Takaki

AU - Kishi, Kentaro

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AU - Ohi, Masaki

AU - Mine, Shinji

AU - Hiki, Naoki

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