title: [Surgical treatment results and prognostic analysis of 514 cases with gastroesophageal junction carcinoma].
abstract: OBJECTIVE
  To clarify the important clinicopathological and therapeutical factors affecting the prognosis of patients with gastroesophageal junction carcinoma.
  
  
  METHODS
  Data of 514 cases with gastroesophageal junction carcinoma who underwent surgical treatment from September 1995 to January 2007 was retrospectively analyzed. Relevant prognostic factors were studied with univariate and multivariate analysis.
  
  
  RESULTS
  For all 514 cases (424 men and 90 women), the median age was 63 years. The 1-, 3- and 5-year survival rates of this group were 74.8%, 42.1% and 29.1%, respectively. Gross type, TNM classification, histological type, vascular invasion and extent of surgical resection affected patients' survival remarkably. There was no significant difference in survival between operative approaches (via laparotomy or left thoracotomy) (P > 0.05). Long-term survival was similar between proximal subtotal gastrectomy and total gastrectomy in advanced cases (P > 0.05). For stage II and III tumors, patients with neoadjuvant chemotherapy had better prognosis than those without (P < 0.05). Cox multivariate regression analysis revealed TNM classification and vascular invasion were independent prognostic factors.
  
  
  CONCLUSIONS
  TNM classification and vascular invasion are independent prognostic factors for gastroesophageal junction carcinoma. Neoadjuvant chemotherapy may improve prognosis of the patients with stage II and III tumors. Radical resection should be achieved with rational surgical procedures tailored by tumor position, size, staging and so on.
authors.affiliation: Department of Gastrointestinal Surgical Oncology, Beijing Cancer Hospital & Institute, Peking University School of Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yang
authors.forename: Ai-wen
authors.initials: AW
authors.lastname: Wu
authors.forename: Zi-yu
authors.initials: ZY
authors.lastname: Li
authors.forename: Zhao-de
authors.initials: ZD
authors.lastname: Bu
authors.forename: Lian-hai
authors.initials: LH
authors.lastname: Zhang
authors.forename: Xiao-jiang
authors.initials: XJ
authors.lastname: Wu
authors.forename: Xiang-long
authors.initials: XL
authors.lastname: Zong
authors.forename: Shuang-xi
authors.initials: SX
authors.lastname: Li
authors.forename: Fei
authors.initials: F
authors.lastname: Shan
authors.forename: Yue
authors.initials: Y
authors.lastname: Yang
authors.forename: Jia-fu
authors.initials: JF
authors.lastname: Ji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D004943:Esophagogastric Junction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*