Long-term outcomes and prognostic factor analysis of resected Siewert type II adenocarcinoma of esophagogastric junction
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RESEARCH ARTICLE
Long‑term outcomes and prognostic factor analysis of resected Siewert type II adenocarcinoma of esophagogastric junction in China: a seven‑year study Yiding Feng1, Youhua Jiang1, Qiang Zhao1, Jinshi Liu1, Hangyu Zhang2 and Qixun Chen1*
Abstract Background: The incidence rate of adenocarcinoma of the esophagogastric junction (AEG) has significantly increased over the past two decades. Surgery remains the only curative treatment. However, there are currently few studies on Chinese AEG patients. The purpose of this study was to retrospectively analyze the survival and prognostic factors of AEG patients in our center. Methods: Between January 2008 and September 2014, 249 AEG patients who underwent radical resection were enrolled in this retrospective study, including 196 males and 53 females, with a median age of 64 (range 31–82). Prognostic factors were assessed with the log-rank test and Cox univariate and multivariate analyses. Results: The 5-year survival rate of all patients was 49%. The median survival time of all enrolled patients was 70.1 months. Pathological type, intraoperative blood transfusion, tumor size, adjuvant chemotherapy, duration of hospital stay, serum CA199, CA125, CA242 and CEA, pTNM stage, lymphovascular or perineural invasion, and the ratio of positive to negative lymph nodes (PNLNR) were significantly associated with overall survival when analyzed in univariate analysis. Conclusions: Our study found that adjuvant chemotherapy, PNLNR, intraoperative blood transfusion, tumor size, perineural invasion, serum CEA, and duration of hospital stay after surgery had significance in multivariate analysis and were independent risk factors for survival. Keywords: Esophagogastric junction adenocarcinoma, Lymph nodes, Siewert classification, Surgery Background Adenocarcinoma of the esophagogastric junction (AEG) has been reported to account for approximately 5–8% [1, 2] of all esophageal cancers in China and 35.7% of gastric cancers and lower esophageal cancers worldwide [3]. Many population-based studies have shown that the *Correspondence: [email protected] 1 Department of Thoracic Surgery, Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital), Hangzhou 31000, China Full list of author information is available at the end of the article
incidence rate of AEG has significantly increased over the past two decades, both in Western countries and in East Asia [4–6]. The reported seven-fold increase in the morbidity rate of AEG [7], which is a more substantial increase compared to that other malignancies, has led to a steady increase in the mortality rate from 2–15/100,000 patients [8]. Surgical resection is the main curative treatment for AEG. Unlike the treatment for gastric cancer, which is standard surgical resection plus D2 lymph node resection, surgery for AEG is still controversial in many ways,
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permi
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