Impact of number and site of lymph node invasion on survival of adenocarcinoma of esophagogastric junction.
Lymph node involvement in adenocarcinoma of the esophagogastric junction (EGJ) is similar to that of gastric cancer. The impact on survival of the number and site of lymph nodes involved in a subgroup of patients undergone surgery for adenocarcinoma of EGJ is reported. Sixty-four patients undergone transthoracic esophagectomy with two-field lymphadenectomy for adenocarcinoma of the EGJ were retrospectively assessed. Five-year survival according to AJCC gastric cancer nodal classification and central node invasion was evaluated. In N0 patients survival was assessed in relation to the number of lymph nodes removed. Five-year survival was 72% in N0, 46% in N1 and 0% in N2 and N3 group. Intergroup differences were statistically significant (P<0.05) except between N2 and N3 groups. Overall survival was different depending on the infiltration of distal or proximal site nodes, 23% vs. 58% (P<0.05); in N0 patients it was related to the number of lymph nodes removed (83% >15 vs. 57% <15, P<0.05). Classification of lymph node involvement in adenocarcinoma of the EGJ by gastric cancer criteria is adequate for prognostic purposes. The involvement of distal nodes in all cases and the removal of <15 nodes in N0 group resulted as independent negative predictive factors.
General and Thoracic Surgery, Clinico S. Carlos University Hospital, Madrid, Spain.
Benedetto
B
Ielpo
Andres Sanchez
AS
Pernaute
Stefano
S
Elia
Oreste Claudio
OC
Buonomo
Luis Diez
LD
Valladares
Elia Perez
EP
Aguirre
Giuseppe
G
Petrella
Antonio Torres
AT
Garcia
D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D016629:Esophagectomy / Q000379:methods / Q000401:mortality; D004943:Esophagogastric Junction / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome