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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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 |
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Affiliation: | Department of Surgical Oncology, National Cancer Center Hospital East, Kashiwa, Japan. ryu37072002@yahoo.co.jp |
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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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