Article Abstract

Retrospectively analysis of the pathology and prognosis of 131 cases of adenocarcinoma of the esophagogastric junction (Siewert type II/III)

Authors: Zifeng Yang, Junjiang Wang, Deqing Wu, Jiabin Zheng, Yong Li

Abstract

Background: The incidence of adenocarcinoma of the esophagogastric junction (AEG) is rising especially in Europe and the United States. Previous studies already characterised its unique location, lymph node metastasis and biological behaviour; and all are obviously different from esophageal and gastric cancer. It has therefore become apparent that also the treatment and prognosis for these adenocarcinomas needs to be adjusted. This study presents the results obtained from a comprehensive analysis of the pathology and prognosis for 131 cases of AEG.
Methods: Clinical data were collected from 131 cases at the Guangdong General Hospital between 2004 and 2012, including follow-up information until October 2016. SPSS software was used for survival analysis.
Results: The study included 82 cases of Siewert type II (63%) and 49 cases of Siewert type III (37%). The average and median survival time was 53 and 42.0 months, respectively, with 91.6%, 52.5% and 36.6% survival rates for one, three and five years respectively. According to Kaplan–Meier Univariate analysis factors that affected prognosis (P<0.05) were: age, the number of hospitalisation days, T stage, N stage, TNM stage, histological differentiation, vascular tumour emboli, tumour size, the number of lymphadenectomies and adjuvant chemotherapy. No correlation (P>0.05) was observed for gender, blood type, Siewert type, surgical approach, surgical resection ways, simultaneous organ resection and comorbidities. Cox Multivariate analysis shows that N stage and the presence of vascular tumor emboli are independent risk factors affecting prognosis.
Conclusions: Factors significantly affecting the prognosis for Siewert type II/III AEG were: age, the number of hospitalisation days, T stage, N stage, TNM stage, histological differentiation, vascular tumour emboli, tumour size, the number of lymphadenectomies and postoperative adjuvant chemotherapy. The N stage and vascular tumour emboli were independent risk factors affecting prognosis.

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