ONCOmmunity

Prognostic and Clinicopathological Significance of Lymph Node Metastasis in the Esophagogastric Junction Adenocarcinoma.

By: Naoki Urakawa, Shingo Kanaji, Satoshi Suzuki, Ryuichiro Sawada, Hitoshi Harada, Hironobu Goto, Hiroshi Hasegawa, Kimihiro Yamashita, Takeru Matsuda, Taro Oshikiri, Yoshihiro Kakeji

Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
2021-11-18; doi: 10.21873/anticanres.15566

Abstract

Background

This study aimed to identify prognostic factors for adenocarcinoma of the esophagogastric junction (AEG) in Siewert type II and characterize the population whose prognosis is expected to improve.

Patients

We retrospectively reviewed a database of 68 AEG type II patients who had undergone surgical curative resection without preoperative treatment.

Results

Although patients with pathological N0 (pN0) showed favorable 3-year disease-free survival (91%), patients with pN1-3 had poor outcomes (42%, 23%, and 10%). Multivariate analyses showed that the only independent prognostic factor was lymph node metastasis, and that tumor depth (cT3-4) and tumor size (≥4 cm) were correlated closely with lymph node metastasis.

Conclusion

Surgical curative resection without preoperative treatment is insufficient to treat AEG type II with lymph node metastasis. Among AEG patients, those with the high-risk factors of preoperative tumor depth (T3-4) or/and size (≥4 cm) might need intensive multimodal treatment, including perioperative adjuvant chemotherapy.