Adenocarcinoma of the esophagogastric junction in Japan.
OBJECTIVE
The prognosis of adenocarcinoma of the esophagogastric junction is worse than that in adenocarcinoma of other parts of the stomach. In particular, the clinical features and prognosis of adenocarcinoma of the esophagogastric junction and the differences between Siewert's type II and III tumors in Japan were evaluated.


METHODS
We analyzed one hundred and forty patients with adenocarcinoma of the esophagogastric junction including one patient with a type I tumor, sixty-seven patients with type II tumors, and seventy-two patients with type III tumors.


RESULTS
The prognosis of patients with type III tumors was poorer in comparison to that of type II tumors in adenocarcinoma of the esophagogastric junction (p<0.05). A significant difference was observed in the survival of patients with type III tumors between those with positive and negative lymph nodes (p<0.001). However, there was no such difference in patients with type II tumors. In a multivariate analysis, lymph node metastasis, age and the depth of tumor invasion were all found to be independent prognostic factors.


CONCLUSIONS
The prognosis of patients with lymph node metastasis of type III adenocarcinoma of the esophagogastric junction was found to be extremely poor. An aggressive treatment after surgery may therefore be necessary to improve the survival of this population.
Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan. mayama@hiroshima-med.jrc.or.jp
Manabu
M
Yamamoto
Hideo
H
Baba
Akinori
A
Egashira
Eiji
E
Oki
Masahiko
M
Ikebe
Yoshihiro
Y
Kakeji
Yoshihiko
Y
Maehara
D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000367:Age Factors; D000368:Aged; D016629:Esophagectomy; D004943:Esophagogastric Junction; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D011379:Prognosis; D016016:Proportional Hazards Models; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery