title: Gastroesophageal junction adenocarcinoma: what are the factors influencing long-term survival?
abstract: The incidence of gastroesophageal junction adenocarcinoma is increasing. About 30% of the tumors cannot be completely resected, and 40% of the patients relapse after complete resection. There is much controversy over the role of neoadjuvant therapy, the approach route, lymphadenectomy, and the extent of esophageal resection. The aim of our study was to report our experience in the treatment of gastroesophageal junction adenocarcinoma. From January 1987 until February 2005, 157 patients (125 men, 32 women), mean age 72.1 +/- 3.2 years, came for observation. One hundred sixteen patients underwent curative intervention. Mean operative time was 185 +/- 45 minutes. Mean postoperative hospital stay was 16.4 +/- 6.1 days. Postoperative complications were observed in 25 patients (21.6%); 6 patients (5.2%) died during the postoperative period. Overall survival was 36.2% and 27.6% at 3- and 5-year follow-up, respectively. Five-year survival rate was significantly lesser in R1/R2 versus R0 resections (0% versus 33.7%), N+ versus N- patients (11.3% versus 53.3%), and worsened with progression of pT histological staging (T1, 100%; T2, 24.1%; T3, 15.1%; T4, 0%). Determining prognostic factors are the radicality of resection, lymph nodal invasion, and histological staging.
authors.affiliation: I Division of General and Gastrointestinal Surgery, Second University of Naples, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: del Genio
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rossetti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Maffettone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Napolitano
authors.forename: Luigi
authors.initials: L
authors.lastname: Brusciano
authors.forename: Gianmattia
authors.initials: G
authors.lastname: del Genio
authors.forename: Gianluca
authors.initials: G
authors.lastname: Russo
authors.forename: Paolo
authors.initials: P
authors.lastname: Limongelli
authors.forename: Irene
authors.initials: I
authors.lastname: Fiume
authors.forename: Francesco
authors.initials: F
authors.lastname: Pizza
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tolone
authors.forename: Maria
authors.initials: M
authors.lastname: Di Martino
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000368:Aged; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D004943:Esophagogastric Junction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate