Esophagogastric Junction Adenocarcinoma According to Siewert Classification in Taiwan
Background The incidence of adenocarcinoma of the esophagogastric junction (AEG) is rapidly increasing. We evaluated the clinicopathological difference and outcomes of Taiwanese patients with AEG according to the Siewert classification. Methods Data were prospectively collected between December 1987...
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Published in | Annals of surgical oncology Vol. 16; no. 12; pp. 3237 - 3244 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York
Springer-Verlag
01.12.2009
Springer Nature B.V |
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Abstract | Background
The incidence of adenocarcinoma of the esophagogastric junction (AEG) is rapidly increasing. We evaluated the clinicopathological difference and outcomes of Taiwanese patients with AEG according to the Siewert classification.
Methods
Data were prospectively collected between December 1987 and July 2007. Two hundred thirty-one patients underwent curative resection of AEG at Taipei Veterans General Hospital and were divided into different Siewert types. The clinicopathological characteristics, operative morbidity, survival, and initial recurrence pattern were compared between the different types.
Results
Fifty-one type II and 180 type III cancer patients were studied. Subtotal esophagectomy via a left thoracotomy (19.6% vs 2.8%), smaller tumor size (4.43 ± 2.04 vs. 5.35 ± 2.03 cm), and more combined organ resection (60% vs. 43.1%) were more common in type II than type III cancer. Multivariate analysis showed that three independent risk factors for death were gender, tumor size, and lymphovascular invasion. There were long-term survivors among the patients with lesser curvature site lymph node metastasis, whereas metastasis to the lymph nodes of the distal stomach and along the greater curvature site was associated with poor prognosis. The 5-year survival was similar between type II and type III cancer (59.6% vs. 63.5%,
P
= 0.947).
Conclusions
Lymphovascular invasion, tumor size, and gender were determined to be three independent factors of survival after curative resection for AEG, and Siewert type was not associated with differences in survival. |
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AbstractList | The incidence of adenocarcinoma of the esophagogastric junction (AEG) is rapidly increasing. We evaluated the clinicopathological difference and outcomes of Taiwanese patients with AEG according to the Siewert classification. Data were prospectively collected between December 1987 and July 2007. Two hundred thirty-one patients underwent curative resection of AEG at Taipei Veterans General Hospital and were divided into different Siewert types. The clinicopathological characteristics, operative morbidity, survival, and initial recurrence pattern were compared between the different types. Fifty-one type II and 180 type III cancer patients were studied. Subtotal esophagectomy via a left thoracotomy (19.6% vs 2.8%), smaller tumor size (4.43 ± 2.04 vs. 5.35 ± 2.03 cm), and more combined organ resection (60% vs. 43.1%) were more common in type II than type III cancer. Multivariate analysis showed that three independent risk factors for death were gender, tumor size, and lymphovascular invasion. There were long-term survivors among the patients with lesser curvature site lymph node metastasis, whereas metastasis to the lymph nodes of the distal stomach and along the greater curvature site was associated with poor prognosis. The 5-year survival was similar between type II and type III cancer (59.6% vs. 63.5%, P = 0.947). Lymphovascular invasion, tumor size, and gender were determined to be three independent factors of survival after curative resection for AEG, and Siewert type was not associated with differences in survival. Background The incidence of adenocarcinoma of the esophagogastric junction (AEG) is rapidly increasing. We evaluated the clinicopathological difference and outcomes of Taiwanese patients with AEG according to the Siewert classification. Methods Data were prospectively collected between December 1987 and July 2007. Two hundred thirty-one patients underwent curative resection of AEG at Taipei Veterans General Hospital and were divided into different Siewert types. The clinicopathological characteristics, operative morbidity, survival, and initial recurrence pattern were compared between the different types. Results Fifty-one type II and 180 type III cancer patients were studied. Subtotal esophagectomy via a left thoracotomy (19.6% vs 2.8%), smaller tumor size (4.43 ± 2.04 vs. 5.35 ± 2.03 cm), and more combined organ resection (60% vs. 43.1%) were more common in type II than type III cancer. Multivariate analysis showed that three independent risk factors for death were gender, tumor size, and lymphovascular invasion. There were long-term survivors among the patients with lesser curvature site lymph node metastasis, whereas metastasis to the lymph nodes of the distal stomach and along the greater curvature site was associated with poor prognosis. The 5-year survival was similar between type II and type III cancer (59.6% vs. 63.5%, P = 0.947). Conclusions Lymphovascular invasion, tumor size, and gender were determined to be three independent factors of survival after curative resection for AEG, and Siewert type was not associated with differences in survival. BACKGROUNDThe incidence of adenocarcinoma of the esophagogastric junction (AEG) is rapidly increasing. We evaluated the clinicopathological difference and outcomes of Taiwanese patients with AEG according to the Siewert classification.METHODSData were prospectively collected between December 1987 and July 2007. Two hundred thirty-one patients underwent curative resection of AEG at Taipei Veterans General Hospital and were divided into different Siewert types. The clinicopathological characteristics, operative morbidity, survival, and initial recurrence pattern were compared between the different types.RESULTSFifty-one type II and 180 type III cancer patients were studied. Subtotal esophagectomy via a left thoracotomy (19.6% vs 2.8%), smaller tumor size (4.43 +/- 2.04 vs. 5.35 +/- 2.03 cm), and more combined organ resection (60% vs. 43.1%) were more common in type II than type III cancer. Multivariate analysis showed that three independent risk factors for death were gender, tumor size, and lymphovascular invasion. There were long-term survivors among the patients with lesser curvature site lymph node metastasis, whereas metastasis to the lymph nodes of the distal stomach and along the greater curvature site was associated with poor prognosis. The 5-year survival was similar between type II and type III cancer (59.6% vs. 63.5%, P = 0.947).CONCLUSIONSLymphovascular invasion, tumor size, and gender were determined to be three independent factors of survival after curative resection for AEG, and Siewert type was not associated with differences in survival. The incidence of adenocarcinoma of the esophagogastric junction (AEG) is rapidly increasing. We evaluated the clinicopathological difference and outcomes of Taiwanese patients with AEG according to the Siewert classification. Data were prospectively collected between December 1987 and July 2007. Two hundred thirty-one patients underwent curative resection of AEG at Taipei Veterans General Hospital and were divided into different Siewert types. The clinicopathological characteristics, operative morbidity, survival, and initial recurrence pattern were compared between the different types. Fifty-one type II and 180 type III cancer patients were studied. Subtotal esophagectomy via a left thoracotomy (19.6% vs 2.8%), smaller tumor size (4.43 +/- 2.04 vs. 5.35 +/- 2.03 cm), and more combined organ resection (60% vs. 43.1%) were more common in type II than type III cancer. Multivariate analysis showed that three independent risk factors for death were gender, tumor size, and lymphovascular invasion. There were long-term survivors among the patients with lesser curvature site lymph node metastasis, whereas metastasis to the lymph nodes of the distal stomach and along the greater curvature site was associated with poor prognosis. The 5-year survival was similar between type II and type III cancer (59.6% vs. 63.5%, P = 0.947). Lymphovascular invasion, tumor size, and gender were determined to be three independent factors of survival after curative resection for AEG, and Siewert type was not associated with differences in survival. |
Author | Hsu, Wen-Hu Fang, Wen-Liang Shen, King-Han Hsieh, Mao-Chih Wu, Chew-Wun Chen, Jen-Hao Lui, Wing-Yiu Lo, Su-Shin Li, Anna Fen-Yau |
Author_xml | – sequence: 1 givenname: Wen-Liang surname: Fang fullname: Fang, Wen-Liang organization: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University – sequence: 2 givenname: Chew-Wun surname: Wu fullname: Wu, Chew-Wun email: cwwu@vghtpe.gov.tw organization: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University – sequence: 3 givenname: Jen-Hao surname: Chen fullname: Chen, Jen-Hao organization: National Yang-Ming University, En Chu Kong Hospital – sequence: 4 givenname: Su-Shin surname: Lo fullname: Lo, Su-Shin organization: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University – sequence: 5 givenname: Mao-Chih surname: Hsieh fullname: Hsieh, Mao-Chih organization: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei Medical College, Affiliated Taipei Municipal Wan-Fang Hospital – sequence: 6 givenname: King-Han surname: Shen fullname: Shen, King-Han organization: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Saint Paul’s Hospital – sequence: 7 givenname: Wen-Hu surname: Hsu fullname: Hsu, Wen-Hu organization: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University – sequence: 8 givenname: Anna Fen-Yau surname: Li fullname: Li, Anna Fen-Yau organization: National Yang-Ming University, Department of Pathology, Taipei Veterans General Hospital – sequence: 9 givenname: Wing-Yiu surname: Lui fullname: Lui, Wing-Yiu organization: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University |
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Keywords | Subtotal Esophagectomy Anastomotic Recurrence Total Gastrectomy Lymphovascular Invasion Taipei Veteran General Hospital |
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The incidence of adenocarcinoma of the esophagogastric junction (AEG) is rapidly increasing. We evaluated the clinicopathological difference and... The incidence of adenocarcinoma of the esophagogastric junction (AEG) is rapidly increasing. We evaluated the clinicopathological difference and outcomes of... BACKGROUNDThe incidence of adenocarcinoma of the esophagogastric junction (AEG) is rapidly increasing. We evaluated the clinicopathological difference and... |
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SubjectTerms | Adenocarcinoma - classification Adenocarcinoma - secondary Adenocarcinoma - surgery Aged Esophageal Neoplasms - classification Esophageal Neoplasms - pathology Esophageal Neoplasms - surgery Esophagogastric Junction - pathology Esophagogastric Junction - surgery Female Follow-Up Studies Gastrointestinal Oncology Humans Lymphatic Metastasis Male Medicine Medicine & Public Health Neoplasm Staging Oncology Prognosis Prospective Studies Surgery Surgical Oncology Survival Rate Treatment Outcome |
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Title | Esophagogastric Junction Adenocarcinoma According to Siewert Classification in Taiwan |
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