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World Journal of Surgery

, Volume 40, Issue 7, pp 1672–1679 | Cite as

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
Original Scientific Report

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.

Keywords

Mediastinal Lymph Node Recurrence Pattern Peritoneal Recurrence Mediastinal Lymph Node Dissection Liver Recurrence 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank Prof. Yuichiro Doki and Prof. Yuko Kitagawa for supervising this study. This study received no grant support.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Tatsuo Matsuda
    • 1
    • 7
  • Yukinori Kurokawa
    • 2
  • Takaki Yoshikawa
    • 3
  • Kentaro Kishi
    • 4
  • Kazunari Misawa
    • 5
  • Masaki Ohi
    • 6
  • Shinji Mine
    • 7
  • Naoki Hiki
    • 7
  • Hiroya Takeuchi
    • 1
  1. 1.Department of SurgeryKeio University School of MedicineTokyoJapan
  2. 2.Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineOsakaJapan
  3. 3.Department of SurgeryKanagawa Cancer CenterYokohamaJapan
  4. 4.Department of SurgeryOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  5. 5.Department of Gastroenterological SurgeryAichi Cancer Center HospitalNagoyaJapan
  6. 6.Department of SurgeryMie University Graduate School of MedicineMieJapan
  7. 7.Department of Gastroenterological SurgeryCancer Institute Hospital, Japanese Foundation for Cancer ResearchTokyoJapan

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