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Esophagus or Stomach? The Seventh TNM Classification for Siewert Type II/III Junctional Adenocarcinoma

  • Gastrointestinal Oncology
  • Published:
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Abstract

Background

The aim of this study is to clarify whether TNM-EC or TNM-GC is better for classifying patients with AEG types II/III.

Methods

The patients who had AEG types II/III and received D1 or more radical lymphadenectomy were selected. The patients were staged both by seventh edition of TNM-EC and TNM-GC. The distribution of the patients, the hazard ratio (HR) of each stage, and the separation of the survival were compared.

Results

A total of 163 patients were enrolled in this study. TNM-EC and TNM-GC classified 25 (20 and 5) and 32 (20 and 12) patients to stage I (IA and IB), 15 (4 and 11), and 33 (11 and 22) to stage II (IIA and IIB), 88 (24, 3, and 61) and 63 (14, 26, and 23) to stage III (IIIA, IIIB, and IIIC), and 35 and 35 to stage IV, respectively. The distribution of the patients was substantially deviated to stage IIIC in TNM-EC but was almost even in TNM-GC. A stepwise increase of HR was observed in TNM-GC, but not in TNM-EC. The survival curves between stages II and III were significantly separated in TNM-GC (P = 0.019), but not in TNM-EC (P = 0.204). The 5-year survival rates of stages IIIA, IIIB, and IIIC were 69.0, 100, and 38.9 % in TNM-EC and were 52.0, 43.4, and 33.9 % in TNM-GC, respectively.

Conclusions

TNM-GC is better for classifying patients with AEG types II/III than TNM-EC is. These results could impact the next TNM revision for AEG.

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Conflict of interest

None declared.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, 241-0815, Japan

    Shinichi Hasegawa MD, Takaki Yoshikawa MD, PhD, Toru Aoyama MD, Tsutomu Hayashi MD, Takanobu Yamada MD, Kazuhito Tsuchida MD, Haruhiko Cho MD & Akira Tsuburaya MD

  2. Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan

    Shinichi Hasegawa MD, Takaki Yoshikawa MD, PhD, Toru Aoyama MD, Tsutomu Hayashi MD, Takanobu Yamada MD, Kazuhito Tsuchida MD, Norio Yukawa MD, Yasushi Rino MD & Munetaka Masuda MD, PhD

  3. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, 4-57　Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan

    Takashi Oshima MD, PhD

Authors
  1. Shinichi Hasegawa MD
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  2. Takaki Yoshikawa MD, PhD
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  3. Toru Aoyama MD
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  4. Tsutomu Hayashi MD
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  5. Takanobu Yamada MD
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  6. Kazuhito Tsuchida MD
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  7. Haruhiko Cho MD
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  8. Takashi Oshima MD, PhD
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  9. Norio Yukawa MD
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  10. Yasushi Rino MD
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  11. Munetaka Masuda MD, PhD
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  12. Akira Tsuburaya MD
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Corresponding author

Correspondence to Takaki Yoshikawa MD, PhD.

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Hasegawa, S., Yoshikawa, T., Aoyama, T. et al. Esophagus or Stomach? The Seventh TNM Classification for Siewert Type II/III Junctional Adenocarcinoma. Ann Surg Oncol 20, 773–779 (2013). https://doi.org/10.1245/s10434-012-2780-x

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  • DOI: https://doi.org/10.1245/s10434-012-2780-x

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